| New Destiny Health | |
|
1072 E Dragon Fly Rd Queen Creek AZ 85143 | |
| (480) 522-0566 | |
| Not Available |
| Full Name | New Destiny Health |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1072 E Dragon Fly Rd, Queen Creek, Arizona |
| Authorized Official Name and Position | Jeff Bolanos (MEMBER-MANAGER) |
| Authorized Official Contact | 4805220566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Destiny Health 530 E Hunt Hwy Suite 103-188 San Tan Valley AZ 85143 Ph: (480) 522-0566 | New Destiny Health 1072 E Dragon Fly Rd Queen Creek AZ 85143 Ph: (480) 522-0566 |
| NPI Number | 1457998551 |
|---|---|
| Provider Enumeration Date | 12/08/2019 |
| Last Update Date | 12/07/2020 |
| Certification Date | 12/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457998551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
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