New Destiny Healing LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

NEW DESTINY HEALING LLC

Practice address

31636 N Cactus Dr
San Tan Valley, AZ 85143-7242

Phone

(626) 710-2595

NPI assigned

Feb 6, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Bolanos

Title

Member

Phone

(626) 710-2595

Specialties & licenses 4

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

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

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 1821794454
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• New Destiny Healing LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Tan Valley, AZ
  • NPI 1821794454
  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": "1831895465",
    "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": "31636 N CACTUS DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851437242",
            "telephone_number": "626-710-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DESTINY HEALING LLC",
        "organizational_subpart": "NO",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.