Organization
AMERICAN COMMUNITY CLINICAL OUTREACH CENTERS
Active
Organization
AMERICAN COMMUNITY CLINICAL OUTREACH CENTERS
Active
Other names
AMECCO-USA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANDRICK C. DARKASHADE PHD (CHIEF ADMINISTRATOR)
(848) 467-1409
Entity
Organization
Contact information
Practice address
285 ROSEVILLE AVE, NEWARK, NJ 07107-1703
(973) 481-2200
Mailing address
610 FOREST VIEW DR, AVENEL, NJ 07001-2176
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
173-040
NJ
251S00000X
Community/Behavioral Health Agency
Primary
173-040
NJ
252Y00000X
Early Intervention Provider Agency
173-040
NJ
261QD1600X
Developmental Disabilities Clinic/Center
173-040
NJ
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
173-040
NJ
261QM0850X
Adult Mental Health Clinic/Center
173-404
NJ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
173-040
NJ
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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