BOLDEN AFC LLC – NPI #1225671621
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

BOLDEN AFC LLC is a residential treatment facility located in SOUTH HAVEN, MI. NPPES has assigned the NPI number 1225671621 to BOLDEN AFC LLC on October 18, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320600000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BOLDEN AFC LLC below.

NPI Profile for
BOLDEN AFC LLC

NPI Number
1225671621
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BOLDEN AFC LLC
Primary location
7027 BASELINE RD
SOUTH HAVEN, MI 49090-8338
Phone: (269) 214-2142 Fax:
Mailing address
71871 10TH AVE
SOUTH HAVEN, MI 49090-9132
Phone: (268) 214-2142 Fax:
Organization Subpart
Yes - BOLDEN AFC LLC is subpart of another organization.
Authorized Official
DORTHIE BOLDEN
OWNER/SUPERVISOR
Phone: (269) 214-2142
Updated
Identifiers

Identifiers for BOLDEN AFC LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMI1235789553
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.