New Destiny Healing LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

NEW DESTINY HEALING LLC

Practice address

2011 W Half Moon Cir
San Tan Valley, AZ 85142-4461

Phone

(626) 710-2595

NPI assigned

Feb 6, 2023

Last updated

Sep 6, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

NEW DESTINY HEALING LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerry Bolanos

Title

Member

Phone

(626) 710-2595

Specialties & licenses 4

Addresses

Tax ID family

New Destiny Healing LLC2 organizations share this tax ID, including this one

Part of

New Destiny Healing LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New Destiny Healing LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Tan Valley, AZ
  • NPI 1831895465
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• New Destiny Healing LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Tan Valley, AZ
  • NPI 1831895465
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788652800000",
    "number": "1821794454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E HUNT HWY STE 103-188",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851436581",
            "telephone_number": "626-710-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 W HALF MOON CIR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851424461",
            "telephone_number": "626-710-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DESTINY HEALING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW DESTINY HEALING LLC",
        "enumeration_date": "2023-02-06",
        "last_updated": "2026-09-06",
        "certification_date": "2026-09-06",
        "status": "A",
        "authorized_official_last_name": "BOLANOS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "626-710-2595"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.