NPIMap

Organization Active NPI

The Redco Group, LLC.

Doing business as Clarvida

  • Adolescent and Children Mental Health Clinic/Center
  • Pottsville, PA
National Provider Identifier
1033289764
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
203110 Issued in PA
Legal business name
THE REDCO GROUP, LLC.
Doing business as
Clarvida
Practice address
210 S Centre St
Pottsville, PA 17901-3501
Phone
(570) 628-5215
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tim Sohosky
Title
C.O.O.
Phone
(570) 628-5215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 203110 PA Primary

Addresses

Primary practice location

210 S Centre St
Pottsville, PA 17901-3501

Mailing address

210 S Centre St
Pottsville, PA 17901-3501
Phone (570) 628-5215

Other identifiers 1

IdentifierTypeStateIssuer
1000017170169MedicaidPA

Other names 1

  • Clarvida Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Redco Group12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1033289764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S CENTRE ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013501",
            "telephone_number": "570-628-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S CENTRE ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013501",
            "telephone_number": "570-628-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REDCO GROUP, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "SOHOSKY",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "570-628-5215"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "203110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000017170169",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.