NPIMap

Organization Active NPI

Cyfd-State of New Mexico-Eagles Nest

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Albuquerque, NM
National Provider Identifier
1720152838
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CYFD-STATE OF NEW MEXICO-EAGLES NEST
Practice address
300 San Mateo Blvd NE Ste 410
Albuquerque, NM 87108-1503
Phone
(505) 377-6911
Fax
(505) 377-6911
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Authorized official

Name
Mr. Minor Morgan, LISW
Title
Bureau Chief, Cyfdjjs Entitlement
Phone
(505) 841-6372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

300 San Mateo Blvd NE Ste 410
Albuquerque, NM 87108-1503

Mailing address

300 San Mateo Blvd NE Ste 410
300 San Mateo Blvd NE Ste 410
Albuquerque, NM 87108-1503
Phone (505) 841-6372

Other names 1

  • Eagles Nest Reintegration Center 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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1720152838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SAN MATEO BLVD NE STE 410",
            "address_2": "300 SAN MATEO BLVD NE STE 410",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081503",
            "telephone_number": "505-841-6372",
            "fax_number": "505-841-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SAN MATEO BLVD NE STE 410",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081503",
            "telephone_number": "505-377-6911",
            "fax_number": "505-377-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYFD-STATE OF NEW MEXICO-EAGLES NEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "MINOR",
        "authorized_official_title_or_position": "BUREAU CHIEF, CYFDJJS ENTITLEMENT",
        "authorized_official_telephone_number": "505-841-6372",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagles Nest Reintegration Center",
            "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 Aug 7, 2008; 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.