NPIMap

Organization Active NPI

Redco Group, LLC

Doing business as Clarvida

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lehighton, PA
National Provider Identifier
1174694897
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
206880 Issued in PA
Legal business name
REDCO GROUP, LLC
Doing business as
Clarvida
Practice address
777 Blakeslee Boulevard Drive East
Lehighton, PA 18235-1464
Phone
(610) 377-8525
Fax
(610) 377-8548
NPI assigned
Nov 13, 2006
Last updated
Mar 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Cassi Group
Title
Director of Operations
Phone
(412) 495-4374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 206880 PA Primary

Addresses

Primary practice location

777 Blakeslee Boulevard Drive East
Lehighton, PA 18235-1464

Mailing address

777 Blakeslee Boulevard Drive East
Lehighton, PA 18235-1464
Phone (610) 377-8525

Other identifiers 1

IdentifierTypeStateIssuer
1000017170558MedicaidPA

Other names 1

  • Clarvida Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000295 PA Part B Supplier - Clinic/Group Practice 7911802228 Receives reassigned benefits from 9 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lehighton, PA; Mifflintown, PA; Milford, PA; Pottsville, PA; Stroudsburg, PA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • Redco Group, LLC

    dba Clarvida

    • Community/Behavioral Health Agency
    • Stroudsburg, PA
    • NPI 1013132190

    O20031201000295

    Same enrollment
  • Redco Group, LLC

    dba Clarvida

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Pottsville, PA
    • NPI 1326024043

    O20031201000295

    Same enrollment
  • Redco Group, LLC

    dba Clarvida

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Pottsville, PA
    • NPI 1376528331

    O20031201000295

    Same enrollment
  • Redco Group, LLC

    dba Clarvida

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Milford, PA
    • NPI 1497731137

    O20031201000295

    Same enrollment
  • Redco Group, LLC

    dba Clarvida

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Stroudsburg, PA
    • NPI 1538145453

    O20031201000295

    Same enrollment

National Provider Directory

National Provider Directory
Tax ID family
Tri County Professional12 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 2

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1174694897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BLAKESLEE BOULEVARD DRIVE EAST",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351464",
            "telephone_number": "610-377-8525",
            "fax_number": "610-377-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BLAKESLEE BOULEVARD DRIVE EAST",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351464",
            "telephone_number": "610-377-8525",
            "fax_number": "610-377-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDCO GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "GROUP",
        "authorized_official_first_name": "CASSI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "412-495-4374"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "206880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000017170558",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lehighton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.