Codac Inc

Methadone Clinic · Pawtucket, RI

Organization Active NPI

NPI number 1629632609

Practice location

600 Pawtucket Ave
Pawtucket, RI 02860-6059
Phone
(401) 808-6278
Fax
(401) 808-6957

Open in Google Maps

NPI record

NPI
1629632609
Entity type
Organization (Type 2)
Enumeration date
April 25, 2019
Last updated
December 21, 2021
Certified
December 21, 2021
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Methadone Clinic Primary 261QM2800X — —
Peer Specialist 175T00000X — —
Public Health or Welfare Agency 251K00000X — —
Primary Care Clinic/Center 261QP2300X — —
Rehabilitation Clinic/Center 261QR0400X — —
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X — —

Mailing address

1052 Park Ave
Cranston, RI 02910-3225
Phone
(401) 275-5038
Fax
(401) 942-3590

Authorized official

Name
Alisha M Bourdeau
Title
CFO
Phone
(401) 275-5038

Other names

  • CODAC Pawtucket Ave

About Codac Inc

Codac Inc is a healthcare organization registered in the NPI registry with the primary taxonomy Methadone Clinic (code 261QM2800X). The practice location is 600 Pawtucket Ave, Pawtucket, RI 02860-6059. The NPI number 1629632609 was assigned on April 25, 2019 and the record was last updated on December 21, 2021.

The authorized official for this organization is Alisha M Bourdeau, CFO.

Frequently asked questions

What is the NPI number of Codac Inc?

The NPI number is 1629632609.

What is the phone number of Codac Inc?

The phone number listed for the practice location is (401) 808-6278.

Where is Codac Inc located?

600 Pawtucket Ave, Pawtucket, RI 02860-6059.

What is the taxonomy code for Codac Inc?

The primary taxonomy code is 261QM2800X – Methadone Clinic; 5 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Methadone Clinic providers in Pawtucket

All Methadone Clinic providers in Pawtucket, RI →