| Codac Behavioral Healthcare | |
|
1052 Park Ave Cranston RI 02910-3225 | |
| (401) 275-5039 | |
| (401) 942-3590 |
| Full Name | Codac Behavioral Healthcare |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1052 Park Ave, Cranston, Rhode Island |
| Authorized Official Name and Position | Alisha Bourdeau (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 4012755039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Codac Behavioral Healthcare 1052 Park Ave Cranston RI 02910-3225 Ph: (401) 275-5039 | Codac Behavioral Healthcare 1052 Park Ave Cranston RI 02910-3225 Ph: (401) 275-5039 |
| NPI Number | 1780082743 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780082743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CDP00575 (Rhode Island) | Primary |
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