DORTHIE BOLDEN (NPI# 1235789553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235789553 |
| Entity Type | Individual |
| Full Name | DORTHIE BOLDEN |
| Practice Address |
7027 Baseline Rd South Haven MI 49090-8338 |
| Mailing Address |
71871 10th Ave South Haven MI 49090-9132 |
| Practice Telephone | 2692142142 |
| Mailing Telephone | 2692142142 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | AS030399514 | MI | Agencies |
| Street Address |
7027 BASELINE RD |
| City | SOUTH HAVEN |
| State | MI |
| Zip Code | 49090-8338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671621 | Bolden Afc LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7027 Baseline Rd, South Haven, MI 49090-8338 | 2019-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295234490 | Katara Therapy, LLC | Social Worker | 13560 76th Street, Suite 3, South Haven, MI 49090 | 2018-02-03 |
| 1487022091 | Kevin E. Ferrell | Physician Assistant | 955 S. Bailey Avenue, South Haven, MI 49090 | 2015-09-14 |
| 1942638002 | Birdie Farley | Chore Provider | 26725 M-140 Hwy, South Haven, MI 49090 | 2013-10-28 |
| 1730514910 | Rebecca A. Bennett | Counselor | 1675 Phoenix Road, Suite 9, South Haven, MI 49090 | 2013-09-06 |
| 1902149818 | Bronson South Haven Hospital | Emergency Medicine | 970 S Bailey Ave, South Haven, MI 49090 | 2013-03-28 |
| 1265629927 | Cecilia Liz Vives Vasquez | Physical Therapist | 23701 Red Arrow Hwy, Mattawan, MI 49090 | 2007-09-26 |
| 1518089788 | Donald Jam,es Buckley | Pharmacist | 955 S Bailey, South Haven, MI 49090 | 2007-04-06 |
| 1366568966 | Norman M Maly | Dentist | 05055 Blue Star Hwy, South Haven, MI 49090 | 2007-03-22 |
| 1639264062 | Deborah Sue Distefano | Pharmacy Technician | 512 Phoenix Street, South Haven, MI 49090 | 2006-10-03 |
| 1053357897 | Stephen Earl Tolen | Chiropractor | 325 Superior St., South Haven, MI 49090 | 2006-06-21 |
| Find all providers in zip 49090 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154823755 | Janell Dawn Missler | Foster Care Agency | 1348 County Road 44, South Haven, MN 55382-9112 | 2018-02-28 |
| 1285180604 | Joyfulliving Adult Foster Care Home | Foster Care Agency | 328 Edgell St, South Haven, MI 49090-1716 | 2016-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474576 | Maryann Michelle Lavender | Foster Care Agency | 5633 Embassy St, Kalamazoo, MI 49009-6499 | 2020-10-13 |
| 1417560269 | Fountain of Love | Foster Care Agency | 2140 Dickerson St, Detroit, MI 48215-2640 | 2020-08-30 |
| 1376165076 | Haven Adult Foster Care Ltd | Foster Care Agency | 73600 Church St, Armada, MI 48005-4749 | 2020-05-15 |
| 1104448018 | Jody Elizabeth Josephson | Foster Care Agency | 7415 Dexter Pinckney Rd, Dexter, MI 48130-7505 | 2020-05-13 |
| 1639701600 | Colonial Park Adult Assisted Living | Foster Care Agency | 1050 W Colonial Park Dr, Grand Ledge, MI 48837-2215 | 2020-02-07 |
| 1972135200 | Absolute Care LLC | Foster Care Agency | 5847 Naneva Ct, West Bloomfield, MI 48322-2517 | 2020-02-05 |
| 1699315556 | Reliance Manor LLC | Foster Care Agency | 35156 Ecorse Rd, Romulus, MI 48174-1640 | 2020-01-08 |
| 1215573217 | Byerly Enterprises, LLC | Foster Care Agency | 8616 Hidden Acre Ct, Clarkston, MI 48348-2895 | 2019-11-25 |
| 1457909509 | Sallie Mae Emert | Foster Care Agency | 2850 W Leinaar Rd, Delton, MI 49046-9567 | 2019-09-02 |
| 1366096638 | Balmoral Living LLC. | Foster Care Agency | 32741 Balmoral Knls, Farmington Hills, MI 48334-1608 | 2019-07-25 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HAVEN |
| Zip Code | 49090 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.