OrganizationTidewater Behavioral Services, LlcBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address2213 Scallop Rd, Virginia Beach, VA 23451-1118(540) 447-0070PECOS EnrollmentBased on the most recent information from CMS, provider Tidewater Behavioral Services, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:48 AM.Profile DetailsProvider ID1265886915Provider TypeOrganizationFull NameTidewater Behavioral Services, LlcSubpartNoEnumeration Date4/19/2016Last Updated4/19/2016Contact InformationPractice LocationPractice Address2213 Scallop Rd, Virginia Beach, VA 23451-1118Phone(540) 447-0070FaxUnlisted FaxMailing LocationMailing Address2213 Scallop Rd, Virginia Beach, VA 23451-1118Phone(540) 447-0070FaxUnlisted FaxAuthorized OfficialNameMorris, Torry Coffey (Bcba, Lba)Phone(540) 447-0070Provider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerVirginia