Provider Demographics
NPI:1346395902
Name:THE OMAHA HOME FOR BOYS
Entity Type:Organization
Organization Name:THE OMAHA HOME FOR BOYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANYE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-457-7107
Mailing Address - Street 1:4343 N 52ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-2803
Mailing Address - Country:US
Mailing Address - Phone:402-457-7000
Mailing Address - Fax:402-457-7162
Practice Address - Street 1:4343 N 52ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2803
Practice Address - Country:US
Practice Address - Phone:402-457-7000
Practice Address - Fax:402-457-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty