Organization
CODAC HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALISHA BOURDEAU (CFO)
(401) 275-5038
Entity
Organization
Contact information
Practice address
349 HUNTINGTON AVE, PROVIDENCE, RI 02909-3005
(401) 942-1450
(401) 946-1550
Mailing address
1052 PARK AVE, CRANSTON, RI 02910-3225
(401) 275-5038
(401) 942-3590
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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