Eastern Services & Camp Simon, LLC
NPI #1902173370 in East Windsor, Connecticut
Provider Information
- NPI Number
- 1902173370
- Entity Type
- Organization
- Organization Name
- Eastern Services & Camp Simon, LLC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Nov 29, 2011
- Last Updated
- Feb 11, 2020
Practice Location
- Address
- 115 BRIDGE ST
- Address 2
- SUITE C
- City
- East Windsor
- State
- Connecticut
- ZIP Code
- 06088-9547
- Phone
- (860) 254-5127
Authorized Official
- Name
- MALY PHIMVONGSA, LPC, NCC
- Title
- DIRECTOR
- Phone
- (860) 254-5127
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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