Provider Demographics
NPI:1548960891
Name:SENTRY PROJECT LLC
Entity type:Organization
Organization Name:SENTRY PROJECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAMBLE
Authorized Official - Suffix:II
Authorized Official - Credentials:BCBA
Authorized Official - Phone:954-234-0918
Mailing Address - Street 1:1931 NW 188TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-2835
Mailing Address - Country:US
Mailing Address - Phone:954-234-0918
Mailing Address - Fax:
Practice Address - Street 1:1931 NW 188TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-2835
Practice Address - Country:US
Practice Address - Phone:954-234-0918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health