FATHER FLANAGAN'S BOYS HOME

Provider Demographics

• NPI: 1265405419
• Name: FATHER FLANAGAN'S BOYS HOME
• Entity type: Organization
• Organization Name: FATHER FLANAGAN'S BOYS HOME
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: CREDENTIALING SPECIALIST
• Authorized Official - First Name: STACIA
• Authorized Official - Middle Name: J
• Authorized Official - Last Name: SHEARMAN
• Authorized Official - Phone: 531-355-8104
• Mailing Address - Street 1: 13460 WALSH DR
• 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 - 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
• Enumeration Date: 2006-02-08
• Last Update Date: 2024-07-25

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Single Specialty
No	101Y00000X	Behavioral Health & Social Service Providers	Counselor		Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NE	100255156-00	Medicaid
NE	100261374-00	Medicaid
NE	100262511-00	Medicaid
NE	100261397-00	Medicaid
NE	100255507-00	Medicaid
NE	100260944-00	Medicaid
NE	100262510-00	Medicaid
NE	100261397-00	Medicaid
NE	=========-26	Medicaid
NE	100255507-00	Medicaid
NE	=========-24	Medicaid
NE	=========31	Medicaid