Provider Demographics
NPI:1811384498
Name:AEGIS TREATMENT CENTERS
Entity Type:Organization
Organization Name:AEGIS TREATMENT CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEYVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFINYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-403-8524
Mailing Address - Street 1:4129 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4129 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1848
Practice Address - Country:US
Practice Address - Phone:805-964-4795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization