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Organization

CYFD-STATE OF NEW MEXICO-EAGLES NEST

Active
Other names
Eagles Nest Reintegration Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MINOR MORGAN LISW (BUREAU CHIEF, CYFDJJS ENTITLEMENT)
(505) 841-6372
Entity
Organization

Contact information

Practice address
300 SAN MATEO BLVD NE STE 410, ALBUQUERQUE, NM 87108-1503
(505) 377-6911
(505) 377-6911
Mailing address
300 SAN MATEO BLVD NE STE 410, 300 SAN MATEO BLVD NE STE 410, ALBUQUERQUE, NM 87108-1503
(505) 841-6372
(505) 841-2949

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
11/20/2006
Last updated
08/07/2008
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