Charaun Bolton
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Philadelphia, PA. Individual provider (NPI-1).
NPI number1851197248
StatusActive
Last updated in NPPESJun 24, 2025
Details
- NPI
- 1851197248
- Entity type
- Individual (NPI-1)
- Name
- Ms. Charaun Bolton
- Sole proprietor
- Yes
- Enumeration date
- Feb 25, 2025
- Certification date
- Jun 24, 2025
- Last updated
- Jun 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 152180 | PA | Yes |
| 2278P3800X | Respiratory Therapist, Certified, Palliative/Hospice | – | – | |
| 253Z00000X | In Home Supportive Care | – | – | |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | – | – | |
| 323P00000X | Psychiatric Residential Treatment Facility | – | – | |
| 376J00000X | Homemaker | – | – | |
| 385H00000X | Respite Care | – | – |
Practice location
5131 Diamond StPhiladelphia, PA 19131-2314
Phone 267-997-2490
Mailing address
7262 Cornelius StPhiladelphia, PA 19138-1618
Phone 267-997-2490
Other practice locations
3136 French St
Philadelphia, PA 19121-1116
Philadelphia, PA 19121-1116
Phone 267-997-2490
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