Organization
CENTRO FEED
Active
Other names
CENTROD FEEDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANDRICK C. DARKASHADE PHD. (PRESIDENT-CEO)
(848) 467-1409
Entity
Organization
Contact information
Practice address
114 FOREST VIEW DR, AVENEL, NJ 07001-2184
(848) 467-1409
Mailing address
114 FOREST VIEW DR, AVENEL, NJ 07001-2184
(848) 467-1409
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
05/04/2020
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