NPIMap

Organization Active NPI

Renew Integrated Program #2

  • Addiction (Substance Use Disorder) Counselor
  • La Puente, CA
National Provider Identifier
1528292356
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
RENEW INTEGRATED PROGRAM #2
Practice address
904 Willow Ave
La Puente, CA 91746-1615
Phone
(626) 931-3000
NPI assigned
May 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Laja Ibraheem, M.D.
Title
Ceo
Phone
(562) 426-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

904 Willow Ave
La Puente, CA 91746-1615

Mailing address

4000 Long Beach Blvd # 228
Long Beach, CA 90807-2617
Phone (562) 426-3300

National Provider Directory

National Provider Directory
Tax ID family
Renew Integrated Program-2 Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1528292356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LONG BEACH BLVD # 228",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072617",
            "telephone_number": "562-426-3300",
            "fax_number": "562-637-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WILLOW AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461615",
            "telephone_number": "626-931-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW INTEGRATED PROGRAM #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "IBRAHEEM",
        "authorized_official_first_name": "LAJA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-426-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.