Healthcare Provider Details

I. General information

NPI: 1578698197
Provider Name (Legal Business Name): ADELANTE DEVELOPMENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 OSUNA RD NE
ALBUQUERQUE NM
87109-4459
US

IV. Provider business mailing address

3900 OSUNA RD NE
ALBUQUERQUE NM
87109-4459
US

V. Phone/Fax

Practice location:
  • Phone: 505-341-2000
  • Fax:
Mailing address:
  • Phone: 505-341-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES H BULLARD
Title or Position: VP - IT
Credential:
Phone: 505-341-2000