Healthcare Provider Details

I. General information

NPI: 1265405419
Provider Name (Legal Business Name): FATHER FLANAGAN'S BOYS HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13460 WALSH DR
BOYS TOWN NE
68010-7529
US

IV. Provider business mailing address

13460 WALSH DR
BOYS TOWN NE
68010-7529
US

V. Phone/Fax

Practice location:
  • Phone: 531-355-3358
  • Fax: 531-355-3375
Mailing address:
  • Phone: 531-355-3358
  • Fax: 531-355-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: BRIDGETTE RENBARGER
Title or Position: CFO
Credential:
Phone: 531-355-3121