Organization
NEW MEXICO DREAM CENTER OF ALBUQUERQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY REPP (CEO)
(505) 217-5060
Entity
Organization
Contact information
Practice address
126 GENERAL CHENNAULT ST NE, ALBUQUERQUE, NM 87123-2515
(505) 900-3833
(505) 212-6422
Mailing address
126 GENERAL CHENNAULT ST NE, ALBUQUERQUE, NM 87123-2515
(505) 900-3833
(505) 212-6422
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023164498
—
NM
Enumeration date
09/20/2022
Last updated
02/13/2025
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