Provider Demographics
NPI:1871767822
Name:AEGIS THERAPIES
Entity type:Organization
Organization Name:AEGIS THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COTA
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-242-5020
Mailing Address - Street 1:3030 CITY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-7900
Mailing Address - Country:US
Mailing Address - Phone:608-242-5020
Mailing Address - Fax:608-467-2683
Practice Address - Street 1:3030 CITY VIEW DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-7900
Practice Address - Country:US
Practice Address - Phone:608-242-5020
Practice Address - Fax:608-467-2683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1905-027314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility