Renew Integrated Program #2 | |
5200 Irwindale Ave Ste 210 Irwindale CA 91706-2014 | |
(626) 960-3964 | |
Not Available |
Full Name | Renew Integrated Program #2 |
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Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 5200 Irwindale Ave Ste 210, Irwindale, California |
Authorized Official Name and Position | Laja Ibraheem (CEO) |
Authorized Official Contact | 5624263300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Renew Integrated Program #2 5200 Irwindale Ave Ste 210 Irwindale CA 91706-2014 Ph: (626) 960-3964 | Renew Integrated Program #2 5200 Irwindale Ave Ste 210 Irwindale CA 91706-2014 Ph: (626) 960-3964 |
NPI Number | 1528292364 |
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Provider Enumeration Date | 05/07/2009 |
Last Update Date | 05/07/2009 |
Identifier | Type | State | Issuer |
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1528292364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |