Organization
BOLTON AND BOLTON COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORTNEY LAKILY BOLTON (OWNER)
(678) 879-3043
Entity
Organization
Contact information
Practice address
1631 CALLAWAY LOOP, CONYERS, GA 30012-3672
(678) 879-3043
Mailing address
1631 CALLAWAY LOOP, CONYERS, GA 30012-3672
(678) 879-3043
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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