Renew Integrated Program-2 INC
NPI #1366883332 in South Gate, California
Provider Information
- NPI Number
- 1366883332
- Entity Type
- Organization
- Organization Name
- Renew Integrated Program-2 INC
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jul 8, 2013
- Last Updated
- Jul 8, 2013
Practice Location
- Address
- 9722 SAN ANTONIO AVE
- City
- South Gate
- State
- California
- ZIP Code
- 90280-4620
- Phone
- (562) 426-3300
Authorized Official
- Name
- DR. LAJA I IBRAHEEM, MD
- Title
- EXECUTIVE DIRECTOR
- Phone
- (562) 426-3300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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