Healthcare Provider Details

I. General information

NPI: 1831020015
Provider Name (Legal Business Name): HOLLYHOMECARELLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 ROUTE STE 200
MOUNT LAUREL NJ
08054
US

IV. Provider business mailing address

3221 ROUTE STE 200
MOUNT LAUREL NJ
08054
US

V. Phone/Fax

Practice location:
  • Phone: 800-698-5038
  • Fax: 855-636-1955
Mailing address:
  • Phone: 800-698-5038
  • Fax: 855-636-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHARI CROOM
Title or Position: CEO
Credential:
Phone: 856-484-1312