CODAC INC NPI 1295731321

NPI Information

NPI: 1295731321
Provider Name: CODAC INC

Doing Business As: CODAC CRANSTON

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
1052 PARK AVE
CODAC CRANSTON
CRANSTON, RI
ZIP 02910
Phone: (401) 461-5056
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CODAC INC is a methadone clinic center in Cranston, RI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. CODAC INC NPI is 1295731321. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Codac Cranston.

The provider's business location address is:

1052 PARK AVE
CODAC CRANSTON
CRANSTON, RI
ZIP 02910
Phone: (401) 461-5056
Fax: (401) 943-2167

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 6/23/2005 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	ACF01632-01	RHODE ISLAND	No
2	251K00000X	Public Health or Welfare		605.1	RHODE ISLAND	No
3	261QM2800X	Clinic/Center	Methadone	605.01	RHODE ISLAND	Yes
4	261QP2300X	Clinic/Center	Primary Care	ACF01632-01	RHODE ISLAND	No
5	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	605.1	RHODE ISLAND	No
6	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	605.01	RHODE ISLAND	No
7	276400000X	Rehabilitation, Substance Use Disorder Unit		605.1	RHODE ISLAND	No
8	175T00000X	Peer Specialist				No

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

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