Lazy Dog Ranch , Inc., a California Corporation

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

LAZY DOG RANCH , INC., A CALIFORNIA CORPORATION

Doing business as

LDR Resource Center

Practice address

34247 Yucaipa Blvd Ste I
Yucaipa, CA 92399-6118

Phone

(909) 599-0871

Fax

(909) 494-5518

NPI assigned

Sep 10, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Christine Louise Gallagher, LPT

Title

Administrator/Co-Owner

Phone

(909) 277-5045

Specialties & licenses 1

Addresses

Other names 1

• LDR Resource Center Doing business as

Locations

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1194208793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1869",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923991452",
            "telephone_number": "909-277-5045",
            "fax_number": "909-494-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34247 YUCAIPA BLVD STE I",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923996118",
            "telephone_number": "909-599-0871",
            "fax_number": "909-494-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAZY DOG RANCH , INC., A CALIFORNIA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "ADMINISTRATOR/CO-OWNER",
        "authorized_official_telephone_number": "909-277-5045",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDR Resource Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yanxi Lan
• David Cody Lange, LMFT
• Lawrence Bray Larson, PHARM. D.
• Kristy Latawiec
• Eric John Laudenslager, M.P.T.
• Anthony Le, PHARMD
• Tara Adrienne Lea, LVN, FNLP
• Lisette Leanos
• Linda Lee, D.P.T.
• Megan Lee

• Substance Use Disorder Rehabilitation Clinic/Center in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.