Whalio Doctors

NPI 1225671621

Bolden Afc LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility South Haven, MI

Practice location

Address
7027 Baseline Rd, South Haven, MI 49090-8338
Phone
(269) 214-2142
Mailing address
71871 10th Ave, South Haven, MI 49090-9132

Authorised official

Name
Dorthie Bolden
Title
Owner/Supervisor
Phone
(269) 214-2142

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X

Registry record

NPI
1225671621
Entity type
Organization
NPI issued
18 Oct 2019
Record last updated
18 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.