NPIMap

Organization Active NPI

Cyfd-State of New Mexico-TCM

  • Case Management Agency
  • Albuquerque, NM
National Provider Identifier
1710053293
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CYFD-STATE OF NEW MEXICO-TCM
Practice address
4000 Edith Blvd NE
Albuquerque, NM 87107-2222
Phone
(505) 841-2400
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Greg Nelson
Title
Bureau Chief, Cyfdjjs
Phone
(505) 331-8562

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X
Case Management Agency 251B00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

4000 Edith Blvd NE
Albuquerque, NM 87107-2222

Mailing address

4000 Edith Blvd NE
Albuquerque, NM 87107-2222
Phone (505) 331-8562

Other practice location 1

10015 Robert Larson
Las Cruces, NM 88007-9005
Phone (575) 526-5900

Other practice location 2

28783 US-64
Eagle Nest, NM 87718
Phone (575) 377-6911

Other practice location 3

3409 Pan American Fwy NE
Albuquerque, NM 87107-4786
Phone (505) 841-4869

Other identifiers 1

IdentifierTypeStateIssuer
74475MedicaidNM

Other names 1

  • Targeted Case Management Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Scientific Laboratory Division Nmdoh43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Locations

300 San Mateo Blvd NE
Ste 410
Albuquerque, NM 87108
Phone (505) 377-6911

4000 Edith Blvd NE
Albuquerque, NM 87107
Phone (505) 841-2400

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1710053293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 EDITH BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871072222",
            "telephone_number": "505-331-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 EDITH BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871072222",
            "telephone_number": "505-841-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10015 Robert Larson",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880079005",
            "country_code": "US",
            "telephone_number": "575-526-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28783 US-64",
            "address_purpose": "LOCATION",
            "city": "Eagle Nest",
            "state": "NM",
            "postal_code": "87718",
            "country_code": "US",
            "telephone_number": "575-377-6911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3409 Pan American Fwy NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871074786",
            "country_code": "US",
            "telephone_number": "505-841-4869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CYFD-STATE OF NEW MEXICO-TCM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "BUREAU CHIEF, CYFDJJS",
        "authorized_official_telephone_number": "505-331-8562",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74475",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Targeted Case Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.