Codac INC
Clinic/Center, Methadone Clinic in East Providence, Rhode Island
1376769919- Practice location
- 850 Waterman Ave, Codac East Bay, East Providence, RI 02914
- Phone
- 401-434-4999
- Fax
- 401-434-6116
- Last updated
- December 21, 2021
Codac INC is a healthcare organization based in East Providence, RI. Codac INC practices in East Providence, RI. The NPI Number for Codac INC is 1376769919 and holds a License No. ACF01632-03 (RI). The current practice location address for Codac INC is 850 Waterman Ave, Codac East Bay, East Providence, RI 02914 and can be reached out via phone at 401-434-4999 and via fax at 401-434-6116.
Provider Profile Details
- NPI Number
- 1376769919
- Provider Name
- Codac INC
- Provider Entity Type
- Organization
- Address
- 850 Waterman Ave, Codac East Bay, East Providence, RI 02914
- Phone Number
- 401-434-4999
- Fax Number
- 401-434-6116
- Primary Taxonomy
- Clinic/Center, Methadone Clinic · 261QM2800X
- Organization Subpart
- No
- Authorized Official
- Ms. Alisha M Bourdeau, BS · Cfo · 401-275-5038
- Other Names
- Codac East Bay (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
- 850 Waterman Ave
Codac East Bay
East Providence, RI 02914 - City
- East Providence
- State
- Rhode Island
- Zip
- 02914
- Phone Number
- 401-434-4999
- Fax Number
- 401-434-6116
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
- License Number (1)
- ACF01632-03
- License State (1)
- RI
- Taxonomy (1)
- Clinic/Center, Primary Care · 261QP2300X
- Taxonomy (2)
- Peer Specialist · 175T00000X
- License Number (3)
- ACF01632-03
- License State (3)
- RI
- Taxonomy (3)
- Family Medicine, Addiction Medicine · 207QA0401X
- License Number (4)
- 605.2
- License State (4)
- RI
- Taxonomy (4)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- License Number (5)
- 605.2
- License State (5)
- RI
- Taxonomy (5)
- Public Health or Welfare · 251K00000X
- License Number (6)
- 605.2
- License State (6)
- RI
- Taxonomy (6)
- Clinic/Center, Methadone Clinic · 261QM2800X
- License Number (7)
- 605.02
- License State (7)
- RI
- Taxonomy (7)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- License Number (8)
- 605.2
- License State (8)
- RI
- Taxonomy (8)
- Rehabilitation, Substance Use Disorder Unit · 276400000X
- License Number (9)
- 605.02
- 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. | |||
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Frequently Asked Questions
What is the NPI number of Codac INC?
The NPI number of Codac INC is 1376769919. 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 ACF01632-03.
Where does Codac INC practice?
The practice location is 850 Waterman Ave, Codac East Bay, East Providence, RI 02914. The office can be reached at 401-434-4999 (phone) or 401-434-6116 (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 1376769919 directly on the NPPES registry website.