Provider Demographics
| NPI: | 1295821825 |
|---|---|
| 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: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BRIDGETTE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | RENBARGER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 531-355-3121 |
| Mailing Address - Street 1: | 555 N 30TH ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | OMAHA |
| Mailing Address - State: | NE |
| Mailing Address - Zip Code: | 68131-2136 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 402-498-6509 |
| Mailing Address - Fax: | 402-498-6357 |
| Practice Address - Street 1: | 555 N 30TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | OMAHA |
| Practice Address - State: | NE |
| Practice Address - Zip Code: | 68131-2136 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 402-498-6509 |
| Practice Address - Fax: | 402-498-6357 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | FATHER FLANAGAN'S BOYS HOME |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2006-10-04 |
| Last Update Date: | 2025-11-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
| No | 363LP0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | Group - Multi-Specialty |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 2080P0201X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology | Group - Multi-Specialty |
| No | 207YP0228X | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology | Group - Multi-Specialty |
| No | 2080P0206X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | Group - Multi-Specialty |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 2080S0010X | Allopathic & Osteopathic Physicians | Pediatrics | Sports Medicine | Group - Multi-Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 2080P0006X | Allopathic & Osteopathic Physicians | Pediatrics | Developmental - Behavioral Pediatrics | Group - Multi-Specialty |
| No | 207SG0201X | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NE | 10025003600 | Medicaid | |
| NE | 02831 | Other | BCBS OF NE GROUP # |
| NE | 10025005900 | Medicaid | |
| NE | 10025171100 | Medicaid | |
| NE | 10025003700 | Medicaid | |
| NE | 10025146300 | Medicaid | |
| NE | =========11 | Medicaid | |
| NE | 10025003700 | Medicaid | |
| NE | =========12 | Medicaid | |
| NE | =========35 | Medicaid | |
| NE | 10025005900 | Medicaid | |
| NE | =========02 | Medicaid | |
| NE | =========64 | Medicaid | |
| NE | 02831 | Other | BCBS OF NE GROUP # |
| NE | 10025146300 | Medicaid | |
| NE | =========15 | Medicaid | |
| NE | 10025171100 | Medicaid | |
| NE | =========35 | Medicaid | |
| NE | 10025003700 | Medicaid |
