Provider Demographics
NPI:1194104034
Name:UNITED SERVICES
Entity type:Organization
Organization Name:UNITED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMERGENCY SERVICES CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JASLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:860-450-1357
Mailing Address - Street 1:132 MANSFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-2027
Mailing Address - Country:US
Mailing Address - Phone:860-456-2261
Mailing Address - Fax:
Practice Address - Street 1:132 MANSFIELD AVE
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2027
Practice Address - Country:US
Practice Address - Phone:860-456-2261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health