CYFD-STATE OF NEW MEXICO-EAGLES NEST (NPI# 1720152838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720152838 |
| Entity Type | Organization |
| Organization Name | CYFD-STATE OF NEW MEXICO-EAGLES NEST |
| Other Organization Name | EAGLES NEST REINTEGRATION CENTER |
| Practice Address |
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 |
| Practice Telephone | 5053776911 |
| Practice Fax Number | 5053776911 |
| Mailing Telephone | 5058416372 |
| Mailing Fax Number | 5058412949 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-08-07 |
| Authorized Official Name | MR. MINOR MORGAN (BUREAU CHIEF, CYFDJJS ENTITLEMENT) |
| Authorized Official Telephone | 5058416372 |
| Authorized Official Credential | LISW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Eagles Nest Reintegration Center | Doing Business As Name - Organization |
| Street Address |
300 SAN MATEO BLVD NE STE 410 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87108-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710053293 | Cyfd-state of New Mexico-tcm | Case Management | 300 San Mateo Blvd Ne Ste 410, 300 San Mateo Blvd Ne Ste 410, Albuquerque, NM 87108-1503 | 2006-11-28 |
| 1124194600 | Cyfd-state of New Mexico-fft | Marriage & Family Therapist | 300 San Mateo Blvd Ne Ste 410, 300 San Mateo Blvd Ne Ste 410, Albuquerque, NM 87108-1503 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
| 1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
| 1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
| 1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
| 1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
| 1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
| 1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
| 1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
| Find all providers in zip 87108 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407990500 | Nm Department of Health | Residential Treatment Facility, Emotionally Disturbed Children | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-02-20 |
| 1699849794 | Cyfd-state of New Mexico | Residential Treatment Facility, Emotionally Disturbed Children | 3409 Pan American Fwy Ne, 3409 Pan American Frwy, Albuquerque, NM 87107-4786 | 2006-11-20 |
| 1972900967 | Holly Bauer | Residential Treatment Facility, Emotionally Disturbed Children | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2014-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407376585 | Amikids Sandoval, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | #20 Pond Road, Sandoval, NM 87013 | 2017-06-21 |
| 1952549875 | Youth Odyssey Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 605 White Mountain Meadows Dr, Ruidoso, NM 88345-5816 | 2009-01-30 |
| 1770721292 | Casa Mesita Group Home, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4007 Sycamore St, Los Alamos, NM 87544-1728 | 2009-01-22 |
| 1942404090 | Zimmerman Consulting, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15 Jemez Drive, Los Lunas, NM 87031-7624 | 2007-06-13 |
| 1497872550 | New Vision Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 919 Rencher St, Clovis, NM 88101-5858 | 2007-03-23 |
| 1124156815 | Villa Santa Maria | Residential Treatment Facility, Emotionally Disturbed Children | 19 Cirquela Rd, Cedar Crest, NM 87008 | 2007-03-02 |
| 1518010222 | Assurance Home Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1000 E 18th St, Roswell, NM 88201-7532 | 2007-01-18 |
| 1962569640 | Our Lady of Mount Carmel | Residential Treatment Facility, Emotionally Disturbed Children | 300 Mount Carmel Ave, Gallup, NM 87301-7411 | 2007-01-02 |
| 1306910484 | Cyfd-state of New Mexico-laplacita | Residential Treatment Facility, Emotionally Disturbed Children | 3102 N Florida Ave, Alamogordo, NM 88310-9713 | 2006-11-20 |
| 1881767366 | Cyfd-state of New Mexico-carlsbad Crf | Residential Treatment Facility, Emotionally Disturbed Children | 106 N Mesquite St, Carlsbad, NM 88220-4960 | 2006-11-15 |
| Find all providers with the same taxonomy | ||||
| City | ALBUQUERQUE |
| Zip Code | 87108 |
Please comment or provide details below to improve the information on CYFD-STATE OF NEW MEXICO-EAGLES NEST.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.