OrganizationActive
Novo Ranch LLC
NPI 1760724280 · Emotionally Disturbed Childrens' Residential Treatment Facility · Roosevelt, UT
Provider details
- NPI number
- 1760724280
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Beau Hancock, Operations Director(435) 823-4472
- License
- 20426 (UT)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
3549 W 1000 North
Roosevelt, UT 84066
Phone: (435) 823-4472
Approximate (ZIP-level) locationGet directions
Mailing address
Rr 4 Box 4407
Roosevelt, UT 84066-9805
Registry dates
- Enumerated
- 2013-03-22
- Last updated
- 2013-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.