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Organization

FATHER FLANAGAN'S BOYS HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA BLAINE (CREDENTIALING SPECIALIST)
(531) 355-3362
Entity
Organization

Contact information

Practice address
14188 MOTHER TERESA LN, BOYS TOWN, NE 68010-7554
(402) 498-3025
(402) 964-7150
Mailing address
14188 MOTHER TERESA LN, BOYS TOWN, NE 68010-7554
(402) 498-3025
(402) 964-7150

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026522510
NE
Enumeration date
07/27/2017
Last updated
02/12/2020
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