| Renew Integrated Program #2 | |
|
5200 Irwindale Ave Ste 210 Irwindale CA 91706-2014 | |
| (626) 960-3964 | |
| Not Available |
| Full Name | Renew Integrated Program #2 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 05/07/2009 |
| Last Update Date | 05/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528292364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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