RYAN JOSEPH NOVAK NPI 1477320190

NPI Information

  • NPI: 1477320190
  • Provider Name: RYAN JOSEPH NOVAK
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Individual
  • Address: 4158 WOODRIDGE DR
    HANNIBAL, MO
    ZIP 63401
  • Phone: (573) 719-7717

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NPI Details

Ryan Joseph Novak is a community based residential treatment facility, intellectual and/or developmental disabilities in Hannibal, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. Ryan Joseph Novak NPI is 1477320190. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4158 WOODRIDGE DR
HANNIBAL, MO
ZIP 63401-248
Phone: (573) 719-7717

The enumeration date for this NPI number is 12/4/2023 and was last updated on 12/4/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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