Organization
LAZY HORSE RANCH
Active
Organization
LAZY HORSE RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN M SUPPLEE BHT (DIRECTOR)
(520) 826-2206
Entity
Organization
Contact information
Practice address
714 N MADISON AVE, BENSON, AZ 85602-6004
(520) 826-2206
Mailing address
3651 E DOE RANCH RD, PEARCE, AZ 85625-6002
(520) 826-2206
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSA09ADHS0188 2
AZ
Other
Enumeration date
02/11/2010
Last updated
02/14/2010
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