OrganizationActive
Codac Inc
NPI 1558712034 · Methadone Clinic · Providence, RI
Provider details
- NPI number
- 1558712034
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Alisha Bourdeau, Cfo(401) 275-5038
- License
- 605.07 (RI)
Specialties & taxonomies
Ambulatory Health Care Facilities
Agencies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
528 N Main St
Providence, RI 02904-5757
Phone: (401) 808-4278
Fax: (401) 808-6957
Street-level locationGet directions
Mailing address
1052 Park Ave
Cranston, RI 02910-3225
Other names (DBA / former)
- Doing business as
- Codac North Main
- Doing business as
- Codac North Main
Registry dates
- Enumerated
- 2016-06-27
- Last updated
- 2019-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.