MEDICARE: VITAL LINK, 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1760139190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL LINK, LLC

Provider Business Mailing Address
First Line	:	29455 N. CAVE CREEK RD.
Second Line	:	STE 118 # 470
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331
Country	:	US
Telephone Number	:	480-877-0037
Fax Number	:	855-930-1406

Provider Business Practice Location Address
First Line	:	6020 E CALLE DE POMPAS
Second Line	:
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331-2509
Country	:	US
Telephone Number	:	480-877-0037
Fax Number	:	855-930-1406

Authorized Official
Title or Position	:	CEO/LEAD ADVOCATE
Name	:	BRIDGET JABLONSKI
Credential	:	RN
Telephone Number	:	480-877-0037

Provider Enumeration Date	:	03/05/2022
Last Update Date	:	04/09/2022

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