CODAC INC NPI 1851513394

NPI Information

NPI: 1851513394
Provider Name: CODAC INC

Other Name: CODAC CORPORATE

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
1052 PARK AVE
CRANSTON, RI
ZIP 02910
Phone: (401) 275-5038
Get Directions

CODAC INC is a rehabilitation and substance use disorder clinic center in Cranston, RI. CODAC INC NPI is 1851513394. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Codac Corporate.

The provider's business location address is:

1052 PARK AVE
CRANSTON, RI
ZIP 02910-225
Phone: (401) 275-5038
Fax: (401) 942-3590

The provider's authorized official is Alisha M Bourdeau .
The authorized official title is Cfo and has the following contact phone number (401) 275-5038.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 12/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	605.00	RHODE ISLAND	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	605.00	RHODE ISLAND	No
3	251K00000X	Public Health or Welfare		605	RHODE ISLAND	No
4	261QM2800X	Clinic/Center	Methadone	605.00	RHODE ISLAND	No
5	261QP2300X	Clinic/Center	Primary Care	ACF01632	RHODE ISLAND	No
6	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	605.0	RHODE ISLAND	Yes
7	276400000X	Rehabilitation, Substance Use Disorder Unit				No
8	276400000X	Rehabilitation, Substance Use Disorder Unit		605	RHODE ISLAND	No
9	175T00000X	Peer Specialist				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CI01382	MEDICAID	RHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »