MEDICARE: VITAL TURN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1396612867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL TURN LLC

Provider Business Mailing Address
First Line	:	9221 E BASELINE RD # 440
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85209-8310
Country	:	US
Telephone Number	:	480-799-3443
Fax Number	:

Provider Business Practice Location Address
First Line	:	9221 E BASELINE RD # 440
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85209-8310
Country	:	US
Telephone Number	:	480-799-3443
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PAUL MAURICE COLLINS JR.
Credential	:
Telephone Number	:	480-799-3443

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/20/2025

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