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13177 Ramona Blvd Suite C Irwindale CA 91706-3855 | |
| (626) 960-4020 | |
| (626) 814-0221 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13177 Ramona Blvd, Irwindale, California |
| Authorized Official Name and Position | Alma Romero (ASS DIRECTOR OF CLAIMS PROCESSING) |
| Authorized Official Contact | 6264631021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 S Santa Anita Ave Arcadia CA 91006-6853 Ph: (626) 254-5000 | 13177 Ramona Blvd Suite C Irwindale CA 91706-3855 Ph: (626) 960-4020 |
| NPI Number | 1013052075 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 01/12/2022 |
| Certification Date | 08/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013052075 | NPI | - | NPPES |
| HOUSING PROGRAM | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Renew Integrated Program #2 Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5200 Irwindale Ave Ste 210, Irwindale, CA 91706 Phone: 626-960-3964 | |