| Name: | CODAC HEALTHCARE, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 12 May 2021 (4 years ago) |
| Identification Number: | 001723769 |
| ZIP code: | 02910 |
| County: | Providence County |
| Principal Address: | 1052 PARK AVENUE, CRANSTON, RI, 02910, USA |
| Purpose: | MEDICAL TREATMENT FOR SUBSTANCE ABUSE |
NAICS
621420 Outpatient Mental Health and Substance Abuse CentersThis industry comprises establishments with medical staff primarily engaged in providing outpatient services related to the diagnosis and treatment of mental health disorders and alcohol and other substance abuse. These establishments generally treat patients who do not require inpatient treatment. They may provide a counseling staff and information regarding a wide range of mental health and substance abuse issues and/or refer patients to more extensive treatment programs, if necessary. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447944111 | 2023-06-06 | 2023-06-06 | 1052 PARK AVE, CRANSTON, RI, 029103225, US | 349 HUNTINGTON AVE, PROVIDENCE, RI, 029093005, US | |||||||||||||||||||
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| Phone | +1 401-275-5038 |
| Fax | 4019423590 |
| Phone | +1 401-942-1450 |
| Fax | 4019461550 |
Authorized person
| Name | MS. ALISHA BOURDEAU |
| Role | CFO |
| Phone | 4012755038 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| STEPHEN F. DEL SESTO, ESQ. | Agent | ONE CITIZENS PLAZA 10TH FLOOR, PROVIDENCE, RI, 02903, USA |
| Number | Name | File Date |
|---|---|---|
| 202449167210 | Annual Report | 2024-03-22 |
| 202330418540 | Annual Report | 2023-03-10 |
| 202328242870 | Statement of Change of Registered/Resident Agent Office | 2023-02-13 |
| 202222451800 | Annual Report | 2022-08-25 |
| 202221121740 | Statement of Change of Registered/Resident Agent | 2022-07-11 |
| 202218871470 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202104908020 | Articles of Amendment | 2021-11-10 |
| 202196491000 | Articles of Organization | 2021-05-12 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
