MEDICARE: FATHER FLANAGANS BOYS HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY6149	FL
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912247396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FATHER FLANAGANS BOYS HOME

Provider Business Mailing Address
First Line	:	1655 PALM BEACH LAKES BLVD STE 300
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2203
Country	:	US
Telephone Number	:	561-612-6000
Fax Number	:	561-612-6097

Provider Business Practice Location Address
First Line	:	1655 PALM BEACH LAKES BLVD STE 300
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2203
Country	:	US
Telephone Number	:	561-612-6000
Fax Number	:	561-612-6097

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	STEVEN ARCIDIACONO
Credential	:	PHD
Telephone Number	:	561-612-6056

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	11/19/2025

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Directions to “FATHER FLANAGANS BOYS HOME ” Practice Location

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