Organization
THE REDCO GROUP, LLC.
Active
Other names
Clarvida
Organization subpart
No
Provider details
NPI number
Authorized official
TIM SOHOSKY (C.O.O.)
(570) 628-5215
Entity
Organization
Contact information
Practice address
210 S CENTRE ST, POTTSVILLE, PA 17901-3501
(570) 628-5215
Mailing address
210 S CENTRE ST, POTTSVILLE, PA 17901-3501
(570) 628-5215
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
203110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000017170169
—
PA
Enumeration date
11/09/2006
Last updated
07/12/2024
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