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13177 Ramona Blvd Suite C Irwindale CA 91706-3855 | |
(626) 960-4020 | |
(626) 960-4076 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 13177 Ramona Blvd, Irwindale, California |
Authorized Official Name and Position | Susan Mandel (PRESIDENT CEO) |
Authorized Official Contact | 6262545000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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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 | 1255476693 |
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Provider Enumeration Date | 02/21/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255476693 | NPI | - | NPPES |
QUALITY IMPROVEMENT | 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 | |