CODAC INC - NPI 1629632609 - Clinic/Center in Pawtucket, RI

Q: What is Codac Inc's NPI number?

The NPI number for Codac Inc is 1629632609. It was assigned to this organization in the NPPES registry on April 25, 2019. The provider is doing business as CODAC Pawtucket Ave.

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.

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About Codac Inc NPPES

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

CODAC INC (NPI 1629632609), doing business as Codac Pawtucket Ave, is a healthcare organization registered as a methadone in Pawtucket, Rhode Island and active in the NPI registry since April 2019. The organization lists Alisha M Bourdeau, Cfo, as its authorized official.

NPPES Registry Identity

NPI1629632609

Entity TypeOrganization

Primary Taxonomy261QM2800X

Legal Business NameCODAC INC

Location Address600 PAWTUCKET AVEPawtucket, RI 02860-6059

Mailing Address1052 Park AveCranston, RI 02910-3225 · (401) 275-5038 · Fax (401) 942-3590

Phone(401) 808-6278

Fax(401) 808-6957

Organization SubpartNo

Authorized OfficialAlisha M BourdeauCfo · (401) 275-5038

Enumeration DateApril 25, 2019

Last NPPES UpdateDecember 21, 20212 updates tracked since enumeration

NPPES CertifiedDecember 21, 2021

✔ NPI 1629632609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities

Taxonomy Code261QM2800X

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 ListedPublic Health or WelfareTaxonomy 251K00000X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

Also ListedClinic/Center · RehabilitationTaxonomy 261QR0400X

Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X

600 PAWTUCKET AVE, Pawtucket, RI 02860

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Other Names 1

Doing Business AsCodac Pawtucket Ave

Other Identifiers 1

MedicaidCO71983RI

Areas of Expertise CMS Part B claims

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.

295 services13 patients

Other Providers at the Same Location NPPES 6

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

MELISSA MCKENNA

Counselor (Mental Health)