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Contact Information

RED DOOR INDIVIDUALIZED LEARNING PROGRAM LLC
30 W COLUMBIA ST
HEMPSTEAD, NY11550-2411
 Phone: 516-385-2323
 Fax: 516-481-4201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Adolescent and Children Mental Health

261QM0855X
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Community/Behavioral Health

251S00000X
 

Developmental Disabilities

261QD1600X
Indicates primary specialty

NPI Profile & details for RED DOOR INDIVIDUALIZED LEARNING PROGRAM LLC

NPI # 1821768375
LBN Legal business name RED DOOR INDIVIDUALIZED LEARNING PROGRAM LLC
Authorized official GREGORY DOMOND - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/16/2021
Last updated 09/16/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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