Basic Information
| Provider Information | |||||||||
| NPI: | 1891454146 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADELANTE HEALTHCARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3033 N CENTRAL AVE | ||||||||
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| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850122809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1623583300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 N GILA BLVD | ||||||||
| Address2: | |||||||||
| City: | GILA BEND | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853371016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778095092 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2021 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| AuthorizedOfficialLastName: | POWELL | ||||||||
| AuthorizedOfficialFirstName: | KRYSTAL | ||||||||
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| AuthorizedOfficialTitleorPosition: | REVENUE CYCLE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6235833001 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.