MEDICARE: MOMCARES GROUP HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1104781665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOMCARES GROUP HOME LLC

Provider Business Mailing Address
First Line	:	21 HIGH ACRE DR
Second Line	:
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-4717
Country	:	US
Telephone Number	:	603-233-6924
Fax Number	:	603-233-6924

Provider Business Practice Location Address
First Line	:	1701 YOSKO DR
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2149
Country	:	US
Telephone Number	:	732-377-9889
Fax Number	:	732-377-9606

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOAN SOI
Credential	:
Telephone Number	:	603-233-6924

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	03/30/2026

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