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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
6103 CRENSHAW BLVD, LOS ANGELES, CA 90043-3946
(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
07/08/2013
Last updated
07/08/2013
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