Organization · NPI-2

American International Clinical Enterprise

Psychologist, Addiction (Substance Use Disorder) · Newark, NJ

NPI number1912424805

StatusActive

Last updated in NPPESAug 23, 2017

Details

NPI: 1912424805
Entity type: Organization (NPI-2)
Legal business name: American International Clinical Enterprise
Organization subpart: No
Enumeration date: Aug 23, 2017
Last updated: Aug 23, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103TA0400X	Psychologist, Addiction (Substance Use Disorder)	173-040	NJ	Yes
251S00000X	Community/Behavioral Health	173-040	NJ
261QM0850X	Clinic/Center, Adult Mental Health	173-040	NJ
261QM0855X	Clinic/Center, Adolescent and Children Mental Health	173-040	NJ
261QM1102X	Clinic/Center, Military Outpatient Operational (Transportable) Component	173-040	NJ
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	173-040	NJ

Other names

Ameice International (Doing Business As)

Practice location

50 Norfolk St
Newark, NJ 07103-3228

Phone 973-623-3362

Mailing address

610 Forest View Dr
Avenel, NJ 07001-2176

Phone 848-467-1409

Authorized official

Candrick C. Darkashade
Clinical Psychologist
8484671409

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