=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558203224
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REVOLUTION RECOVERY SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 LAFAYETTE RD UNIT 1
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01952-1520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-519-0665
-----------------------------------------------------
Fax | 978-519-0665
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 211 LAFAYETTE RD UNIT 1
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01952-1520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-519-0665
-----------------------------------------------------
Fax | 978-519-0665
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | AMANDA TOOMEY
-----------------------------------------------------
Credential | TOOMEY
-----------------------------------------------------
Telephone | 978-519-0665
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------