Organization
LAZY DOG RANCH , INC., A CALIFORNIA CORPORATION
Active
Other names
LDR Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINE LOUISE GALLAGHER LPT (ADMINISTRATOR/CO-OWNER)
(909) 277-5045
Entity
Organization
Contact information
Practice address
34247 YUCAIPA BLVD STE I, YUCAIPA, CA 92399-6118
(909) 599-0871
(909) 494-5518
Mailing address
PO BOX 1869, YUCAIPA, CA 92399-1452
(909) 277-5045
(909) 494-5518
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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