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Ryan Joseph Novak
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Hannibal, Missouri
NPI 1477320190

Ryan Joseph Novak is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Hannibal, MO. Ryan Joseph Novak practices in Hannibal, MO. The NPI Number for Ryan Joseph Novak is 1477320190 and holds a License No. (Missouri).

The current practice location address for Ryan Joseph Novak is 4158 Woodridge Dr, Hannibal, MO and can be reached out via phone at 573-719-7717. You can also correspond with Ryan Joseph Novak through the mailing address at 4158 WOODRIDGE DR, HANNIBAL, MO - 63401-6248 (mailing address contact number: ).

Location: 4158 Woodridge Dr, Hannibal, MO, 63401-6248
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477320190
Provider Name
Ryan Joseph Novak
Credential
Provider Entity Type
Individual
Gender
Male
Address
4158 Woodridge Dr, Hannibal, MO, 63401-6248
Phone Number
573-719-7717
Fax Number
Provider Enumeration Date
12/04/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4158 Woodridge Dr
City
Hannibal
State
Missouri
Zip
63401-6248
Phone Number
573-719-7717
Fax Number
person
Provider Business Mailing Address Details
Address
4158 Woodridge Dr
City
Hannibal
State
Missouri
Zip
63401-6248
Phone Number
573-719-7717
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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