NOVO RANCH LLC (NPI# 1760724280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760724280 |
| Entity Type | Organization |
| Organization Name | NOVO RANCH LLC |
| Practice Address |
3549 W 1000 North Roosevelt UT 84066 |
| Mailing Address |
Rr 4 Box 4407 Roosevelt UT 84066-9805 |
| Practice Telephone | 4358234472 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |
| Authorized Official Name | BEAU D HANCOCK (OPERATIONS DIRECTOR) |
| Authorized Official Telephone | 4358234472 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 20426 | UT | Residential Treatment Facilities |
| Street Address |
3549 W 1000 NORTH |
| City | ROOSEVELT |
| State | UT |
| Zip Code | 84066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075315 | Annemarie Rousseau | Registered Nurse | 250 West 300 North, Roosevelt, UT 84066 | 2017-07-12 |
| 1780036772 | Drew Gilley | Dentist | 375 E Lagoon St, Roosevelt, Ut 84066, Roosevelt, UT 84066 | 2016-07-01 |
| 1952758039 | Amanda Adams | Massage Therapist | 1151 East Hwy 40, Ballard, UT 84066 | 2016-05-19 |
| 1447624325 | Gregory George Page | Dentist | 209 West 200 North 71-2, Roosevelt, UT 84066 | 2015-11-16 |
| 1659785772 | Becky Ann Birch | Nurse Practitioner | 200 West 350 North, Ste 103, Roosevelt, UT 84066 | 2014-06-17 |
| 1508110040 | Uintah Basin Spine and Disc Center, PC | Rehabilitation Unit | 1151 East Highway 40, Roosevelt, UT 84066 | 2012-11-06 |
| 1184918682 | Alvaro Beltran | Dentist | Ave. Lopez Mateos 171-4, Nogales, SONORA 84066 | 2011-06-02 |
| 1255638367 | Cosme Cantu | Dentist | Blvd. El Greco #45 Int. J-14, Nogales, SONORA 84066 | 2011-02-25 |
| 1740482009 | Northeastern Utah Medical Group | Durable Medical Equipment & Medical Supplies | 210 W 300 N 75 3, Roosevelt, UT 84066 | 2007-05-31 |
| 1851436471 | Dan Ray Robinson | Dentist | 675 South Rodeo Drive, Roosevelt, UT 84066 | 2007-02-21 |
| Find all providers in zip 84066 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639400989 | Cedar Ridge, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | Rr 1 Box 1477, Roosevelt, UT 84066-9735 | 2010-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013167 | Elevated Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 10928 S Eureka Dune Dr, South Jordan, UT 84009-4173 | 2020-11-04 |
| 1003430133 | Cascade Academy | Residential Treatment Facility, Emotionally Disturbed Children | 430 W 200 N, Midway, UT 84049 | 2020-06-04 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1083107320 | Red Circle Lodge, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 930 N Memorial St, Hildale, UT 84784 | 2018-06-12 |
| 1023560679 | Meridian Mentoring | Residential Treatment Facility, Emotionally Disturbed Children | 635 South Main St., Orangeville, UT 84537 | 2016-10-31 |
| 1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
| 1033592290 | Keystone Family Support, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2558 Valley View Dr, Layton, UT 84040-7654 | 2015-07-07 |
| 1285033977 | Utah Family Care LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3575 S 3200 W Apt 6c, West Valley City, UT 84119-3571 | 2014-08-19 |
| 1982011649 | Teen Discovery Home | Residential Treatment Facility, Emotionally Disturbed Children | 10 East 100 South, Gunnison, UT 84634 | 2014-07-15 |
| 1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NOVO RANCH LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.