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 1558712034

Codac Inc is a Peer Specialist in Providence, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2016.

Licensed in
RI
In the registry since
2016
Specialties on file
7
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

528 N Main St
Providence, RI 02904-5757
Phone: (401) 808-4278
Fax: (401) 808-6957
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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 605.07 (RI)
Peer Specialist Taxonomy 175T00000X
Public Health or Welfare Agency Taxonomy 251K00000X · Licence 605.07 (RI)
Health Service Clinic/Center Taxonomy 261QH0100X · Licence 605.07 (RI)
Primary Care Clinic/Center Taxonomy 261QP2300X · Licence ACF01632 (RI)
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X · Licence 605.07 (RI)
Substance Use Disorder Rehabilitation Hospital Unit Taxonomy 276400000X · Licence 605.07 (RI)

Record details

NPI number1558712034
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alisha Bourdeau — Cfo · (401) 275-5038
Other names Codac North Main; Codac North Main
NPI enumeratedJune 27, 2016
Last updated in NPPESApril 25, 2019
Mailing address1052 Park Ave, Cranston, RI 02910-3225

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