CODAC PROVIDENCE
NPI 1215153945
Clinic/Center - Methadone in Providence, RI

Q: What is Codac Inc's NPI number?

The NPI number for Codac Inc is 1215153945. It was assigned to this organization in the NPPES registry on April 18, 2007. The provider is doing business as Codac Providence.

Q: What is Codac Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Q: When was this NPI record last updated?

The NPPES record for Codac Inc was last updated on December 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 18, 2007

349 HUNTINGTON AVE, CODAC PROVIDENCE, PROVIDENCE, RI 02909(401) 942-1450(401) 946-1550 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 21, 2021, Apr 25, 2019, Mar 29, 2017 (3 updates tracked since 2017).

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About Codac Providence NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CODAC PROVIDENCE (NPI 1215153945) is a healthcare organization registered as a methadone in Providence, Rhode Island and active in the NPI registry since April 2007. The organization lists Alisha M Bourdeau, Cfo, as its authorized official.

NPPES Registry Identity

NPI1215153945

Entity TypeOrganization

Primary Taxonomy261QM2800X

Legal Business NameCODAC INC

Location Address349 HUNTINGTON AVE, CODAC PROVIDENCEProvidence, RI 02909

Mailing Address1052 Park AveCranston, RI 02910 · (401) 275-5038 · Fax (401) 942-3590

Phone(401) 942-1450

Fax(401) 946-1550

Organization SubpartNo

Authorized OfficialAlisha M BourdeauCfo · (401) 275-5038

Enumeration DateApril 18, 2007

Last NPPES UpdateDecember 21, 20213 updates tracked since enumeration

NPPES CertifiedDecember 21, 2021

✔ NPI 1215153945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities

Taxonomy Code261QM2800X

Licenses✔ Licensed in RI · 605.05✔ Licensed in RI · 605.5

Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Also ListedPeer SpecialistTaxonomy 175T00000X

Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X · License ACF01632 (RI)

Also ListedPublic Health or WelfareTaxonomy 251K00000X · License 605.5 (RI)

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License ACF01632 (RI)

Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X · License 605.05 (RI), 605.5 (RI)

Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X · License 605.5 (RI)

349 HUNTINGTON AVE, Providence, RI 02909

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Other Names 1

Doing Business AsCodac Providence

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm G2067

Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.

666 services40 patients

Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure G2078

This service provides an additional 7-day supply of methadone, a medication used to treat opioid addiction, for patients to take at home. It's provided by a Medicare-enrolled opioid treatment program. This service is billed separately from the main treatment procedure.

86 services15 patients

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARON ANN TATALO MS

Counselor (Addiction (Substance Use Disorder))