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Organization
RENEW INTEGRATED PROGRAM #2
Active
Organization
RENEW INTEGRATED PROGRAM #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAJA IBRAHEEM M.D. (CEO)
(562) 426-3300
Entity
Organization
Contact information
Practice address
904 WILLOW AVE, LA PUENTE, CA 91746-1615
(626) 931-3000
Mailing address
4000 LONG BEACH BLVD # 228, LONG BEACH, CA 90807-2617
(562) 426-3300
(562) 637-3244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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