| NPI | 1295731321 |
|---|---|
| Doing Business As | CODAC CRANSTON |
| Entity Type | Organization |
| Authorized Contact | ALISHA M BOURDEAU CFO 401-275-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: RI 605.01) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: RI 605.01) |
| 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: RI 605.1) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: RI ACF01632-01) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: RI 605.1) | |
| 175T00000X Peer Specialist | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: RI ACF01632-01) | |
| 251K00000X Public Health or Welfare (Licence: RI 605.1) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2021-12-21 |