Codac Providence

LBN: Codac Inc
Codac Providence is an health care organization with primary practice located at 349 Huntington Ave Codac Providence, Providence RI 02909. The organization recently has 7 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Allopathic & Osteopathic Physicians / Addiction Medicine, Agencies / Public Health or Welfare, Ambulatory Health Care Facilities / Methadone, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, Hospital Units / Rehabilitation, Substance Use Disorder Unit. Ambulatory Health Care Facilities / Methadone is the primary health care specialty. Codac Inc can be contacted via phone (401) 942-1450, or through Bourdeau, Alisha M via phone (401) 275-5038.

Contact Information

Primary practice address
349 Huntington Ave Codac Providence Providence RI 02909
Phone: (401) 942-1450
Fax: (401) 946-1550
Website:
Map and Directions
Authorized official contact:
Name: Bourdeau, Alisha M BS
Phone: (401) 275-5038

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X ACF01632 Rhode Island
Agencies / Public Health or Welfare 251K00000X 605.5 Rhode Island
Ambulatory Health Care Facilities / Methadone 261QM2800X 605.5 Rhode Island
Ambulatory Health Care Facilities / Methadone 261QM2800X 605.05 Rhode Island
Ambulatory Health Care Facilities / Primary Care 261QP2300X ACF01632 Rhode Island
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 605.5 Rhode Island
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 605.05 Rhode Island
Hospital Units / Rehabilitation, Substance Use Disorder Unit 276400000X 605.5 Rhode Island

Profile Details

NPI number 1215153945
LBN Legal business name Codac Inc
DBA Doing business as Codac Providence
Authorized official Bourdeau, Alisha M BS
Entity Organization
Organization subpart 1 No
Enumeration date Apr 18th, 2007
Last updated Dec 21st, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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