MEDICARE: ADELANTE DEVELOPMENT CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist
2	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578698197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADELANTE DEVELOPMENT CENTER, INC.

Provider Business Mailing Address
First Line	:	3900 OSUNA RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4459
Country	:	US
Telephone Number	:	505-341-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 OSUNA RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4459
Country	:	US
Telephone Number	:	505-341-2000
Fax Number	:

Authorized Official
Title or Position	:	VP - IT
Name	:	MR. JAMES H BULLARD
Credential	:
Telephone Number	:	505-341-2000

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/11/2025

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