MEDICARE: RESILIENCE BEHAVIORAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1023984150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENCE BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	1600 PROVIDENCE HWY STE 100
Second Line	:
City	:	WALPOLE
State	:	MA
Zip	:	02081-2557
Country	:	US
Telephone Number	:	774-266-6570
Fax Number	:

Provider Business Practice Location Address
First Line	:	2780 MORRIS AVE STE 2D
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4848
Country	:	US
Telephone Number	:	774-266-6570
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	AMANDA TOMASELLO
Credential	:
Telephone Number	:	774-266-6570

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	01/07/2026

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