| Renew Integrated Program-2 Inc. | |
|
4324 W Jefferson Blvd Los Angeles CA 90016-4115 | |
| (562) 426-3300 | |
| Not Available |
| Full Name | Renew Integrated Program-2 Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4324 W Jefferson Blvd, Los Angeles, California |
| Authorized Official Name and Position | Laja I Ibraheem (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5624263300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Integrated Program-2 Inc. Po Box 20140 Long Beach CA 90801-3140 Ph: (562) 426-3300 | Renew Integrated Program-2 Inc. 4324 W Jefferson Blvd Los Angeles CA 90016-4115 Ph: (562) 426-3300 |
| NPI Number | 1164869319 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 05/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164869319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A66124 (California) | Primary |
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