Organization
NEW DESTINY HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY BOLANOS (MEMBER)
(626) 710-2595
Entity
Organization
Contact information
Practice address
31636 N CACTUS DR, SAN TAN VALLEY, AZ 85143-7242
(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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