| NPI | 1558712034 |
|---|---|
| Doing Business As | CODAC NORTH MAIN |
| Entity Type | Organization |
| Authorized Contact | ALISHA BOURDEAU CFO 401-275-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: RI 605.07) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: RI 605.07) |
| 261QH0100X Clinic/Center, Health Services (Licence: RI 605.07) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: RI ACF01632) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: RI 605.07) | |
| 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: RI 605.07) | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2019-04-25 |