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Organization
RENEW INTEGRATED PROGRAM-2 INC.
Active
Organization
RENEW INTEGRATED PROGRAM-2 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAJA I IBRAHEEM MD (EXECUTIVE DIRECTOR)
(562) 426-3300
Entity
Organization
Contact information
Practice address
4205 E ALONDRA BLVD, COMPTON, CA 90221-4234
(562) 426-3300
Mailing address
PO BOX 20140, LONG BEACH, CA 90801-3140
(562) 426-3300
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A66124
CA
Other
Enumeration date
05/29/2013
Last updated
08/15/2013
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