CODAC CRANSTON
NPI 1295731321
Clinic/Center - Methadone in Cranston, RI

Q: What is Codac Inc's NPI number?

The NPI number for Codac Inc is 1295731321. It was assigned to this organization in the NPPES registry on June 23, 2005. The provider is doing business as Codac Cranston.

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 June 23, 2005

1052 PARK AVE, CODAC CRANSTON, CRANSTON, RI 02910(401) 461-5056(401) 943-2167 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 21, 2021, Apr 25, 2019, Sep 22, 2017 and 1 more (4 updates tracked since 2017).

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About Codac Cranston NPPES

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

CODAC CRANSTON (NPI 1295731321) is a healthcare organization registered as a methadone in Cranston, Rhode Island and active in the NPI registry since June 2005. The organization lists Alisha M Bourdeau, Cfo, as its authorized official.

NPPES Registry Identity

NPI1295731321

Entity TypeOrganization

Primary Taxonomy261QM2800X

Legal Business NameCODAC INC

Location Address1052 PARK AVE, CODAC CRANSTONCranston, RI 02910

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

Phone(401) 461-5056

Fax(401) 943-2167

Organization SubpartNo

Authorized OfficialAlisha M BourdeauCfo · (401) 275-5038

Enumeration DateJune 23, 2005

Last NPPES UpdateDecember 21, 20214 updates tracked since enumeration

NPPES CertifiedDecember 21, 2021

✔ NPI 1295731321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities

Taxonomy Code261QM2800X

License✔ Licensed in RI · 605.01

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 ACF01632-01 (RI)

Also ListedPublic Health or WelfareTaxonomy 251K00000X · License 605.1 (RI)

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License ACF01632-01 (RI)

Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X · License 605.1 (RI), 605.01 (RI)

Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X · License 605.1 (RI)

1052 PARK AVE, Cranston, RI 02910

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Other Names 1

Doing Business AsCodac Cranston

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

Other Providers at the Same Location NPPES 20

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

LISA L LANGLOIS LCDP

Counselor (Addiction (Substance Use Disorder))