# NOVO RANCH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760724280
- **Authorized official:** BEAU D HANCOCK (OPERATIONS DIRECTOR)
- **Authorized official phone:** (435) 823-4472

## Contact information

- **Practice address:** 3549 W 1000 NORTH, ROOSEVELT, UT 84066
- **Practice address phone:** (435) 823-4472
- **Mailing address:** RR 4 BOX 4407, ROOSEVELT, UT 84066-9805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 20426 | UT | Yes |

## Other

- **Enumeration date:** 03/22/2013
- **Last updated:** 03/22/2013