Organization
RED DOOR THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY DOMOND (OWNER)
(516) 784-1041
Entity
Organization
Contact information
Practice address
30 W COLUMBIA ST, HEMPSTEAD, NY 11550-2411
(516) 385-2323
(516) 385-5306
Mailing address
535 S FRANKLIN ST, HEMPSTEAD, NY 11550-7619
(516) 385-2323
(516) 385-5306
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194088526
NPI
—
01
—
1740764190
NPI
—
01
—
1841582764
NPI
—
Enumeration date
07/20/2020
Last updated
09/14/2021
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