Individual
MS. CHARAUN BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
5131 DIAMOND ST, PHILADELPHIA, PA 19131-2314
(267) 997-2490
Mailing address
7262 CORNELIUS ST, PHILADELPHIA, PA 19138-1618
(267) 997-2490
Taxonomy
Speciality
Code
Description
License number
State
2278P3800X
Palliative/Hospice Certified Respiratory Therapist
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
152180
PA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/25/2025
Last updated
06/24/2025
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