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Organization
RENEW BEHAVORIAL HEALTH INC
Active
Organization
RENEW BEHAVORIAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAJA I IBRAHEEM MD (MD OWNER)
(562) 637-3143
Entity
Organization
Contact information
Practice address
4000 LONG BEACH BLVD, STE 228, LONG BEACH, CA 90807-2617
(562) 637-3143
(562) 637-3244
Mailing address
PO BOX 20140, LONG BEACH, CA 90801-3140
(562) 637-3143
(562) 637-3244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A66124
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A661240
—
CA
Enumeration date
07/18/2006
Last updated
08/22/2020
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