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Organization

REDCO GROUP, LLC

Active
Other names
Clarvida
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIM SOHOSKY (COO)
(570) 628-5215
Entity
Organization

Contact information

Practice address
16 S CENTRE ST, POTTSVILLE, PA 17901-3001
(570) 628-5234
(570) 628-9051
Mailing address
16 S CENTRE ST, POTTSVILLE, PA 17901-3001
(570) 628-5234
(570) 628-9051

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
209010
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000017170155
PA
Enumeration date
12/13/2005
Last updated
07/12/2024
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