Provider Demographics
NPI:1710275714
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:EXECUTIVE V.P/DIRECTOR OF YOUTH CAR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-498-1928
Mailing Address - Street 1:3230 W WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-9609
Mailing Address - Country:US
Mailing Address - Phone:308-381-4444
Mailing Address - Fax:308-381-6124
Practice Address - Street 1:3230 W WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-9609
Practice Address - Country:US
Practice Address - Phone:308-381-4444
Practice Address - Fax:308-381-6124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty