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NEW DESTINY HEALTH LLC NPI 1457998551


NPI Information

NPI: 1457998551
Provider Name: NEW DESTINY HEALTH LLC

Other Name: NEW DESTINY HEALTH

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 03D2295715

Address:
1072 E DRAGON FLY RD
QUEEN CREEK, AZ
ZIP 85143
Phone: (480) 522-0566
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NEW DESTINY HEALTH LLC is a community behavioral health in Queen Creek, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. NEW DESTINY HEALTH LLC NPI is 1457998551. The provider is registered as an organization entity type.
The provider Other Name Is New Destiny Health.

The provider's business location address is:

1072 E DRAGON FLY RD
QUEEN CREEK, AZ
ZIP 85143
Phone: (480) 522-0566

The provider's authorized official is Jeff Bolanos .
The authorized official title is Member-manager and has the following contact phone number (480) 522-0566.

The CLIA number assigned to this NPI record is 03D2295715 - other - behavioral health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/8/2019 and was last updated on 12/7/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
2251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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