Provider Demographics
NPI:1821960303
Name:HOLLYHOMECARE AGENCY
Entity type:Organization
Organization Name:HOLLYHOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOKER HOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-221-2597
Mailing Address - Street 1:1072 TREMONT DR
Mailing Address - Street 2:
Mailing Address - City:GLENOLDEN
Mailing Address - State:PA
Mailing Address - Zip Code:19036-1521
Mailing Address - Country:US
Mailing Address - Phone:215-221-2597
Mailing Address - Fax:
Practice Address - Street 1:1072 TREMONT DR
Practice Address - Street 2:
Practice Address - City:GLENOLDEN
Practice Address - State:PA
Practice Address - Zip Code:19036-1521
Practice Address - Country:US
Practice Address - Phone:215-221-2597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities