RENEW INTEGRATED PROGRAM #2 INC. (NPI# 1932333630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932333630 |
| Entity Type | Organization |
| Organization Name | RENEW INTEGRATED PROGRAM #2 INC. |
| Practice Address |
755 Ardilla Ave La Puente CA 91746-2163 |
| Mailing Address |
4000 Long Beach Blvd. #228 Long Beach Blvd. CA 90807 |
| Practice Telephone | 6269313000 |
| Mailing Telephone | 5624263300 |
| Mailing Fax Number | 5626373244 |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2009-05-08 |
| Authorized Official Name | MR. LAJA IBRAHEEM (CEO) |
| Authorized Official Telephone | 5624263300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
755 ARDILLA AVE |
| City | LA PUENTE |
| State | CA |
| Zip Code | 91746-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528438843 | Jason Trinidad | Specialist/Technologist | 755 Ardilla Ave, La Puente, CA 91746-2163 | 2015-09-29 |
| 1922304856 | Wings of Refuge, Inc. | Exclusive Provider Organization | 755 Ardilla Ave, Room A102, La Puente, CA 91746-2163 | 2011-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891291688 | Kelsey Harrold | Marriage & Family Therapist | 13200 Crossroads Pkwy, #335, City of Industry, CA 91746 | 2018-04-02 |
| 1013428804 | Special Service for Groups, Inc. | Community Based Residential Treatment Facility, Mental Illness | 13139 Don Julian Rd., La Puente, CA 91746 | 2017-10-19 |
| 1982733689 | Fenghua Fu D.d.s., A Professional Corporation | Dentist | 13704 Amar Rd, La Puente, CA 91746 | 2007-03-06 |
| 1306989942 | Kira Kristine Au | Specialist/Technologist | 14301 Fairgrove Ave, La Puente, CA 91746 | 2007-02-14 |
| 1609978055 | Los Angeles Dental Office | Dentist | 13704 E Anar Rd, La Puente, CA 91746 | 2006-09-05 |
| 1639140346 | Professional Nurses Group, Inc. | Homemaker | 13181 Crossroads Pkwy N Ste 322, City of Industry, CA 91746 | 2006-01-30 |
| 1952888331 | Joshua Rios | Case Manager/Care Coordinator | 160 S 7th Ave, La Puente, CA 91746 | 2018-07-27 |
| 1447709175 | Evelyn Chavez | Counselor | 160 S 7th Ave, La Puente, CA 91746 | 2016-09-22 |
| 1295102861 | Leticia Miramontes Pelayo I | Counselor | 160 S 7th Ave, La Puente, CA 91746 | 2015-08-30 |
| 1619369196 | Samantha Valle | Case Manager/Care Coordinator | 160 S 7th Ave, La Puente, CA 91746 | 2015-02-20 |
| Find all providers in zip 91746 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508342957 | Liliana Mejia | Counselor | 15613 Doublegrove St, La Puente, CA 91744-1108 | 2018-07-18 |
| 1508211095 | Amber Solorzano | Counselor | 17046 Main St, La Puente, CA 91744-5018 | 2016-05-03 |
| 1902271943 | Marina Rodriguez | Counselor | 514 Broadmoor Ave, La Puente, CA 91744-3613 | 2015-12-02 |
| 1336487354 | Wendi M Looney | Counselor | 915 Cabana Ave, La Puente, CA 91744-1702 | 2013-01-25 |
| 1881163574 | Ashley P. Bullock | Counselor | 15229 Amar Rd, La Puente, CA 91744-2066 | 2018-11-25 |
| 1871061788 | Kissthopher C Mendoza | Counselor | 15229 Amar Rd, La Puente, CA 91744-2066 | 2018-11-08 |
| 1104306430 | Bianca Desiree Medina | Counselor | 15229 E Amar Rd, La Puente, CA 91744 | 2018-08-16 |
| 1114433927 | Nico Tank | Counselor | 15229 Amar Rd, La Puente, CA 91744-2066 | 2017-12-18 |
| 1629587944 | Luis David Perez | Counselor | 160 S 7th Ave, La Puente, CA 91746-3211 | 2017-09-29 |
| 1639690720 | Michelle Solis | Counselor | 15229 Amar Rd, La Puente, CA 91744-2066 | 2017-06-29 |
| Find all providers in LA PUENTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.