Codac INC
Clinic/Center, Methadone Clinic in Providence, Rhode Island
1215153945- Practice location
- 349 Huntington Ave, Codac Providence, Providence, RI 02909
- Phone
- 401-942-1450
- Fax
- 401-946-1550
- Last updated
- December 21, 2021
Codac INC is a healthcare organization based in Providence, RI. Codac INC practices in Providence, RI. The NPI Number for Codac INC is 1215153945 and holds a License No. ACF01632 (RI). The current practice location address for Codac INC is 349 Huntington Ave, Codac Providence, Providence, RI 02909 and can be reached out via phone at 401-942-1450 and via fax at 401-946-1550.
Provider Profile Details
- NPI Number
- 1215153945
- Provider Name
- Codac INC
- Provider Entity Type
- Organization
- Address
- 349 Huntington Ave, Codac Providence, Providence, RI 02909
- Phone Number
- 401-942-1450
- Fax Number
- 401-946-1550
- Primary Taxonomy
- Clinic/Center, Methadone Clinic · 261QM2800X
- Organization Subpart
- No
- Authorized Official
- Ms. Alisha M Bourdeau, BS · Cfo · 401-275-5038
- Other Names
- Codac Providence (Doing Business As)
- Provider Enumeration Date
- April 18, 2007
- Last Update Date
- December 21, 2021
- Certification Date
- December 21, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 349 Huntington Ave
Codac Providence
Providence, RI 02909 - City
- Providence
- State
- Rhode Island
- Zip
- 02909
- Phone Number
- 401-942-1450
- Fax Number
- 401-946-1550
Provider Business Mailing Address Details
- Address
- 1052 Park Ave
Cranston, RI 02910 - City
- Cranston
- State
- RI
- Zip
- 02910
- Phone Number
- 401-275-5038
- Fax Number
- 401-942-3590
License Information
- Taxonomy (1)
- Peer Specialist · 175T00000X
- License Number (2)
- ACF01632
- License State (2)
- RI
- Taxonomy (2)
- Family Medicine, Addiction Medicine · 207QA0401X
- License Number (3)
- 605.5
- License State (3)
- RI
- Taxonomy (3)
- Public Health or Welfare · 251K00000X
- License Number (4)
- 605.5
- License State (4)
- RI
- Taxonomy (4)
- Clinic/Center, Methadone Clinic · 261QM2800X
- License Number (5)
- ACF01632
- License State (5)
- RI
- Taxonomy (5)
- Clinic/Center, Primary Care · 261QP2300X
- License Number (6)
- 605.5
- License State (6)
- RI
- Taxonomy (6)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- License Number (7)
- 605.05
- License State (7)
- RI
- Taxonomy (7)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- License Number (8)
- 605.5
- License State (8)
- RI
- Taxonomy (8)
- Rehabilitation, Substance Use Disorder Unit · 276400000X
- License Number (9)
- 605.05
- License State (9)
- RI
- Taxonomy (9)
- Clinic/Center, Methadone Clinic · 261QM2800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Clinic/Center, Methadone Clinic providers near Providence, RI
View all Clinic/Center, Methadone Clinic providers in Providence →Frequently Asked Questions
What is the NPI number of Codac INC?
The NPI number of Codac INC is 1215153945. It was assigned on April 18, 2007 and is currently active in the NPPES registry.
What is the specialty of Codac INC?
Codac INC is registered under the primary taxonomy Clinic/Center, Methadone Clinic (code 261QM2800X), licensed in RI under license number ACF01632.
Where does Codac INC practice?
The practice location is 349 Huntington Ave, Codac Providence, Providence, RI 02909. The office can be reached at 401-942-1450 (phone) or 401-946-1550 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1215153945 directly on the NPPES registry website.