Organization
HOMEHAVENVILLAGELLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMANI WHITESIDE (OWNER)
(757) 615-7921
Entity
Organization
Contact information
Practice address
3549 TYRE NECK RD, PORTSMOUTH, VA 23703-3321
(757) 615-7921
Mailing address
3549 TYRE NECK RD, PORTSMOUTH, VA 23703-3321
(757) 615-7921
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/21/2026
Last updated
01/21/2026
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