Organization
NEW DESTINY HEALING LLC
Active
Parent organization
NEW DESTINY HEALING LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW DESTINY HEALING LLC
Authorized official
JERRY BOLANOS (MEMBER)
(626) 710-2595
Entity
Organization
Contact information
Practice address
2011 W HALF MOON CIR, SAN TAN VALLEY, AZ 85142-4461
(626) 710-2595
Mailing address
530 E HUNT HWY STE 103-188, SAN TAN VALLEY, AZ 85143-6581
(626) 710-2595
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
04/16/2026
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