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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
1785 E 85TH ST, LOS ANGELES, CA 90001-4057
(562) 426-3300
(562) 637-3244
Mailing address
PO BOX 20140, LONG BEACH, CA 90801-3140
(562) 426-3300
(562) 637-3244
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A66124
CA
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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