Codac INC

NPI #1215153945 in Providence, Rhode Island

Provider Information

NPI Number: 1215153945
Entity Type: Organization
Organization Name: Codac INC
Primary Specialty: Peer Specialist
Enumeration Date: Apr 18, 2007
Last Updated: Dec 21, 2021

Practice Location

Address: 349 HUNTINGTON AVE
Address 2: CODAC PROVIDENCE
City: Providence
State: Rhode Island
ZIP Code: 02909
Phone: (401) 942-1450

Authorized Official

Name: MS. ALISHA M BOURDEAU, BS
Title: CFO
Phone: (401) 275-5038

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary
Family Medicine - Addiction Medicine — Addiction Medicine	207QA0401X
Public Health or Welfare	251K00000X
Clinic/Center - Methadone — Methadone	261QM2800X
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Rehabilitation, Substance Use Disorder Unit	276400000X

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