| NPI | 1689769705 |
|---|---|
| Doing Business As | CHCA ADOLESCENT MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MIXZA SANTA Enrollment Manager 267-425-9233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-10-21 |