MEDICARE: HOLLYHOMECARELLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831020015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLYHOMECARELLC

Provider Business Mailing Address
First Line	:	3221 ROUTE STE 200
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054
Country	:	US
Telephone Number	:	800-698-5038
Fax Number	:	855-636-1955

Provider Business Practice Location Address
First Line	:	3221 ROUTE STE 200
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054
Country	:	US
Telephone Number	:	800-698-5038
Fax Number	:	855-636-1955

Authorized Official
Title or Position	:	CEO
Name	:	SHARI CROOM
Credential	:
Telephone Number	:	856-484-1312

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “HOLLYHOMECARELLC ” Practice Location

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