| NPI | 1215715875 |
|---|---|
| Doing Business As | CCA DIRECT |
| Entity Type | Organization |
| Authorized Contact | TODD STEVEN BREEDEN COO 619-213-8147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2023-09-15 |