Provider Demographics
NPI:1073609798
Name:FATHER FLANAGAN'S BOYS' HOME
Entity Type:Organization
Organization Name:FATHER FLANAGAN'S BOYS' HOME
Other - Org Name:BOYS TOWN BEHAVORIAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:F
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-498-3131
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-498-6509
Mailing Address - Fax:402-498-6357
Practice Address - Street 1:555 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2136
Practice Address - Country:US
Practice Address - Phone:402-498-6509
Practice Address - Fax:402-498-6357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FATHER FLANAGAN'S BOYS HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-04
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEMHC001322D00000X
NE08558143322D00000X
NE23058955322D00000X
NEMHC010323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========30Medicaid
NE=========27Medicaid
NE=========28Medicaid
NE=========29Medicaid
NE=========25Medicaid