Organization
THE 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 STREET, SUITE 28, POTTSVILLE, PA 17901
(570) 622-6417
Mailing address
208 S CENTRE ST, POTTSVILLE, PA 17901-3501
(570) 622-6417
(570) 622-3230
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
203110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000017170169
—
PA
05
—
1000017170571
—
PA
Enumeration date
12/13/2005
Last updated
10/11/2024
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