Clinic/Center, Methadone Clinic
CODAC INC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1376769919 · enumerated 2007-04-18 · record updated 2021-12-21. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Ms. ALISHA BOURDEAU BS, CFO · (401) 275-5038
Other names: CODAC EAST BAY
Addresses and phones
- Practice location 850 WATERMAN AVE, CODAC EAST BAY, EAST PROVIDENCE, RI, 02914 (401) 434-4999 Fax (401) 434-6116 Google Maps Apple Maps OpenStreetMap
- Mailing address 1052 PARK AVE, CRANSTON, RI, 02910 (401) 275-5038 Fax (401) 942-3590 Google Maps Apple Maps OpenStreetMap
Specialties
- Clinic/Center, Primary Care 261QP2300X · License ACF01632-03 RI
- Peer Specialist 175T00000X
- Family Medicine, Addiction Medicine 207QA0401X · License ACF01632-03 RI
- Clinic/Center, Rehabilitation, Substance Use Disorder 261QR0405X · License 605.2 RI
- Public Health or Welfare 251K00000X · License 605.2 RI
- Clinic/Center, Methadone Clinic 261QM2800X · License 605.2 RI
- Clinic/Center, Rehabilitation, Substance Use Disorder 261QR0405X · License 605.02 RI
- Rehabilitation, Substance Use Disorder Unit 276400000X · License 605.2 RI
- Clinic/Center, Methadone Clinic 261QM2800X · Primary · License 605.02 RI
In this directory
RI Providence County East Providence Clinic/Center, Methadone Clinic
Locations and evidence
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Practice location
EAST PROVIDENCE, RI, 02914
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.