Eastern Services & Camp Simon LLC
NPI #1538582739 in Windsor Locks, Connecticut
Provider Information
- NPI Number
- 1538582739
- Entity Type
- Organization
- Organization Name
- Eastern Services & Camp Simon LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Jan 24, 2014
- Last Updated
- Feb 11, 2020
Practice Location
- Address
- 82 MAIN ST
- City
- Windsor Locks
- State
- Connecticut
- ZIP Code
- 06096-2325
- Phone
- (860) 254-5127
Authorized Official
- Name
- MALY PHIMVONGSA
- Title
- CLINICAL DIRECTOR/OWNER
- Phone
- (860) 254-5127
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
| Counselor - Professional — Professional |
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