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General NPI Number Information
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NPI Number | 1851526669
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Entity Type | Organization
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Legal Business Name | THE REDCO GROUP, LLC
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 210 S CENTRE ST
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City | POTTSVILLE
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State | PA
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Zip | 17901-3501
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Country | US
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Telephone | 570-628-5215
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Fax | 570-624-4825
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Provider Business Mailing Address
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Address Line | 210 S CENTRE ST
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City | POTTSVILLE
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State | PA
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Zip | 17901-3501
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Country | US
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Telephone | 570-628-5215
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Fax | 570-624-4825
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Authorized Official
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Title or Position | C.O.O.
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Name | MR. TIM SOHOSKY
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Credential |
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Telephone | 570-628-5215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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