MEDICARE: ADELANTE BEHAVIORAL HEALTH ABA LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1700473766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADELANTE BEHAVIORAL HEALTH ABA LLC

Provider Business Mailing Address
First Line	:	513 W COLUMBUS ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5848
Country	:	US
Telephone Number	:	559-759-5060
Fax Number	:	661-579-1536

Provider Business Practice Location Address
First Line	:	513 W COLUMBUS ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5848
Country	:	US
Telephone Number	:	559-759-5060
Fax Number	:	661-579-1536

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	CARLOS PEREZ FLORES
Credential	:	MS, BCABA
Telephone Number	:	559-759-5060

Provider Enumeration Date	:	12/24/2020
Last Update Date	:	01/30/2024

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