Provider Demographics
NPI:1265405419
Name:FATHER FLANAGAN'S BOYS HOME
Entity type:Organization
Organization Name:FATHER FLANAGAN'S BOYS HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RENBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-355-3121
Mailing Address - Street 1:13460 WALSH DR
Mailing Address - Street 2:
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-7529
Mailing Address - Country:US
Mailing Address - Phone:531-355-3358
Mailing Address - Fax:531-355-3375
Practice Address - Street 1:13460 WALSH DR
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7529
Practice Address - Country:US
Practice Address - Phone:531-355-3358
Practice Address - Fax:531-355-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025550700Medicaid
NE100262511-00Medicaid
NE100261374-00Medicaid
NE100262510-00Medicaid
NE100255507-00Medicaid
NE10026522533Medicaid
NE10025745300Medicaid
NE100260944-00Medicaid
NE100261397-00Medicaid
NE100255156-00Medicaid
NE=========-24Medicaid
NE=========31Medicaid