Healthcare Provider Details

I. General information

NPI: 1114846672
Provider Name (Legal Business Name): REVOLUTIONS BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 N BLACK HORSE PIKE STE 6
WILLIAMSTOWN NJ
08094-2840
US

IV. Provider business mailing address

1035 N BLACK HORSE PIKE STE 6
WILLIAMSTOWN NJ
08094-2840
US

V. Phone/Fax

Practice location:
  • Phone: 561-523-9418
  • Fax:
Mailing address:
  • Phone: 561-523-9418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA FALATOVICH
Title or Position: CEO
Credential:
Phone: 561-523-9418