# RENEW INTEGRATED PROGRAM-2 INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033479993
- **Authorized official:** DR. LAJA I. IBRAHEEM MD (OWNER)
- **Authorized official phone:** (562) 426-3300

## Contact information

- **Practice address:** 14135 FAIRGROVE AVE, LA PUENTE, CA 91746-1708
- **Practice address phone:** (562) 426-3300
- **Practice address fax:** (562) 637-3244
- **Mailing address:** 4000 LONG BEACH BLVD, 228, LONG BEACH, CA 90807-2617
- **Mailing address phone:** (562) 426-3300
- **Mailing address fax:** (562) 637-3244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | A66124 | CA | Yes |

## Other

- **Enumeration date:** 05/24/2012
- **Last updated:** 05/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7205 | — | CA |