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Organization

IN MY HOME CARE SUPPORT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE DOMINIQUE WILLIAMS (OWNER)
(757) 405-7307
Entity
Organization

Contact information

Practice address
739 HIGH ST STE 122, PORTSMOUTH, VA 23704-3425
(757) 405-7307
(804) 535-4699
Mailing address
739 HIGH ST STE 122, PORTSMOUTH, VA 23704-3425
(757) 405-7307
(804) 535-4699

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
253Z00000X
In Home Supportive Care Agency
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
03/11/2026
Last updated
03/11/2026
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