{
  "npi": "1134565740",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "DENISE",
    "authorized_official_last_name": "WINANT",
    "authorized_official_telephone_number": "7325700268",
    "authorized_official_title_or_position": "Credentialing Supervisor",
    "certification_date": "2024-02-16",
    "enumeration_date": "2013-05-22",
    "last_updated": "2024-02-16",
    "organization_name": "AEGIS TREATMENT CENTERS, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "955 W. CENTER STREET,",
      "address_2": "SUITES 12A, 12B & 14",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MANTECA",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "95337",
      "state": "CA",
      "telephone_number": "209-239-9600"
    },
    {
      "address_1": "1317 ROUTE 73 STE 200",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MOUNT LAUREL",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "080542202",
      "state": "NJ",
      "telephone_number": "856-439-6111"
    }
  ],
  "taxonomies": [
    {
      "code": "261QR0405X",
      "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
      "license": "39-14",
      "primary": false,
      "state": "CA",
      "taxonomy_group": ""
    },
    {
      "code": "261QM2800X",
      "desc": "Clinic/Center, Methadone Clinic",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": {
    "total_beneficiaries": "21",
    "total_services": "775",
    "total_medicare_allowed_amt": "199466.25",
    "top_hcpcs_services": [
      {
        "code": "G2067",
        "description": "Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm",
        "services": "726",
        "beneficiaries": "19"
      }
    ]
  },
  "enrichment": {
    "plain_english_specialty": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": []
  }
}