# BOLDEN AFC LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOLDEN AFC LLC
- **Other names:** Diamond Pointe
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225671621
- **Legal business name:** BOLDEN AFC LLC
- **Authorized official:** DORTHIE BOLDEN (OWNER/SUPERVISOR)
- **Authorized official phone:** (269) 214-2142

## Contact information

- **Practice address:** 7027 BASELINE RD, SOUTH HAVEN, MI 49090-8338
- **Practice address phone:** (269) 214-2142
- **Mailing address:** 71871 10TH AVE, SOUTH HAVEN, MI 49090-9132
- **Mailing address phone:** (268) 214-2142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2019
- **Last updated:** 10/18/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1235789553 | — | MI |