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General NPI Number Information
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NPI Number | 1710275714
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Entity Type | Organization
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Legal Business Name | FATHER FLANAGAN'S BOYS HOME
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 3230 W WILDWOOD DR
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City | GRAND ISLAND
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State | NE
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Zip | 68801-9609
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Country | US
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Telephone | 308-381-4444
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Fax | 308-381-6124
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Provider Business Mailing Address
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Address Line | 3230 W WILDWOOD DR
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City | GRAND ISLAND
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State | NE
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Zip | 68801-9609
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Country | US
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Telephone | 308-381-8851
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Fax | 308-381-8853
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Authorized Official
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Title or Position | CFO
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Name | BRIDGETTE RENBARGER
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Credential |
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Telephone | 531-355-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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