Healthcare Provider Details

I. General information

NPI: 1417528647
Provider Name (Legal Business Name): ADELANTE DEVELOPMENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 LAFAYETTE DR NE
ALBUQUERQUE NM
87107-4367
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: 505-341-2001
Mailing address:
  • Phone: 505-449-4039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: REBECCA LYNN SANFORD
Title or Position: PRESIDENT & CEO
Credential:
Phone: 505-341-2000