Eastern Services & Camp Simon, Llc

LBN: Eastern Services & Camp Simon, Llc
Eastern Services & Camp Simon, Llc is an health care organization with primary practice located at 115 Bridge St Suite C, East Windsor CT 06088-9547. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as the primary health care specialty. Eastern Services & Camp Simon, Llc can be contacted via phone (860) 254-5127, or through Phimvongsa, Maly via phone (860) 254-5127.

Contact Information

Primary practice address
115 Bridge St Suite C East Windsor CT 06088-9547
Phone: (860) 254-5127
Fax: (860) 254-5254
Website:
Map and Directions
Authorized official contact:
Name: Phimvongsa, Maly LPC, NCC
Phone: (860) 254-5127

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 001470 Connecticut

Profile Details

NPI number 1902173370
LBN Legal business name Eastern Services & Camp Simon, Llc
DBA Doing business as
Authorized official Phimvongsa, Maly LPC, NCC
Entity Organization
Organization subpart 1 No
Enumeration date Nov 29th, 2011
Last updated Feb 11th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902173370 NPPES
Connecticut MEDICAID 004257053

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