NPIMap

Organization Active NPI

Renew Integrated Program-2 Inc

  • Community/Behavioral Health Agency
  • Los Angeles, CA
National Provider Identifier
1730520701
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
A66124 Issued in CA
Legal business name
RENEW INTEGRATED PROGRAM-2 INC
Practice address
3801 S Broadway
Los Angeles, CA 90037
Phone
(562) 426-3300
Fax
(562) 637-3244
NPI assigned
Jul 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Authorized official

Name
Dr. Laja I Ibraheem, MD
Title
Executive Director
Phone
(562) 426-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X A66124 CA Primary

Addresses

Primary practice location

3801 S Broadway
Los Angeles, CA 90037

Mailing address

PO Box 20140
Long Beach, CA 90801-3140
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

Locations

3801 S Broadway
Los Angeles, CA 90037

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1730520701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20140",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908013140",
            "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": "3801 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90037",
            "telephone_number": "562-426-3300",
            "fax_number": "562-637-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW INTEGRATED PROGRAM-2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "IBRAHEEM",
        "authorized_official_first_name": "LAJA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "562-426-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "A66124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; 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.