# HOLY MOBA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194345025
- **Authorized official:** MERCY A GBORSON (MANAGING MEMBER)
- **Authorized official phone:** (973) 289-3614

## Contact information

- **Practice address:** 136 W 3RD AVE APT 13, ROSELLE, NJ 07203-1268
- **Practice address phone:** (973) 289-3614
- **Mailing address:** 485C US HIGHWAY 1 S STE 100, ISELIN, NJ 08830-3016
- **Mailing address phone:** (973) 289-3614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 04/21/2020
- **Last updated:** 06/15/2021