Provider Demographics
NPI:1114370566
Name:THE GEMINI PROJECT, LLC
Entity Type:Organization
Organization Name:THE GEMINI PROJECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:APELLANIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:302-377-5190
Mailing Address - Street 1:141 WESTON ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06101-9002
Mailing Address - Country:US
Mailing Address - Phone:302-377-5190
Mailing Address - Fax:
Practice Address - Street 1:705 N MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-1412
Practice Address - Country:US
Practice Address - Phone:302-377-5190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health