Organization
EQUAL AND DIVERSE BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENNILLE SMITH (CEO)
(757) 998-0125
Entity
Organization
Contact information
Practice address
780 LYNNHAVEN PKWY STE 400, VIRGINIA BEACH, VA 23452-7332
(757) 998-0125
Mailing address
350 FAIRWAY DR STE 101, DEERFIELD BEACH, FL 33441-1834
(877) 418-2978
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/25/2024
Last updated
06/17/2025
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