Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Codac Inc

Organization Peer Specialist · NPI 1215153945

Codac Inc is a Peer Specialist in Providence, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2007.

Licensed in
RI
In the registry since
2007
Specialties on file
9
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

349 Huntington Ave Codac Providence
Providence, RI 02909
Phone: (401) 942-1450
Fax: (401) 946-1550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Methadone Clinic (primary) Taxonomy 261QM2800X · Licence 605.05 (RI)
Peer Specialist Taxonomy 175T00000X
Addiction Medicine (Family Medicine) Physician Taxonomy 207QA0401X · Licence ACF01632 (RI)
Public Health or Welfare Agency Taxonomy 251K00000X · Licence 605.5 (RI)
Methadone Clinic Taxonomy 261QM2800X · Licence 605.5 (RI)
Primary Care Clinic/Center Taxonomy 261QP2300X · Licence ACF01632 (RI)
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X · Licence 605.5 (RI)
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X · Licence 605.05 (RI)
Substance Use Disorder Rehabilitation Hospital Unit Taxonomy 276400000X · Licence 605.5 (RI)

Record details

NPI number1215153945
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alisha Bourdeau — Cfo · (401) 275-5038
Other names Codac Providence; Codac Providence
NPI enumeratedApril 18, 2007
Last updated in NPPESDecember 21, 2021
Certification dateDecember 21, 2021
Mailing address1052 Park Ave, Cranston, RI 02910

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