NPIMap

Organization Active NPI

Mennonite General Hospital Inc

Doing business as Centro de Salud Conductual Menonita CIMA-Humacao

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Humacao, PR
National Provider Identifier
1487371399
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MENNONITE GENERAL HOSPITAL INC
Doing business as
Centro de Salud Conductual Menonita CIMA-Humacao
Practice address
Boulevard del Rio Office Building a-3
Ramal 3, Bo Ctano
Humacao, PR 00791-0073
Phone
(787) 434-1700
Fax
(787) 434-1711
NPI assigned
Oct 21, 2022
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MENNONITE GENERAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lissette Vasquez Rivera
Title
Director
Phone
(787) 434-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

Boulevard del Rio Office Building a-3
Ramal 3, Bo Ctano
Humacao, PR 00791-0073

Mailing address

PO Box 1650
Cidra, PR 00739-1650
Phone (787) 434-1700

Other identifiers 1

IdentifierTypeStateIssuer
6OtherPRLICENCIA OPERACIONAL

Other names 1

  • Centro de Salud Conductual Menonita CIMA-Humacao Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lvazquez@mghpr.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100907001150 PR Part A Provider - Hospital 6709843964 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aibonito, PR; Caguas, PR; Cayey, PR; Guayama, PR; Humacao, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487371399. Details of each certification follow.

Hospital certification: CCN 404009

Legal name
MENNONITE GENERAL HOSPITAL INC
Doing business as
CENTRO DE SALUD CONDUCTUAL MENONITA CIMA
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Mar 9, 2011
Last certification
Feb 6, 2025
Beds
61 (20 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1976 in PR
Enrollment address
Calle Sargento Gerardo Santiago
Carr 14 KM HM 50.4
Aibonito, PR 705
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Centro de Salud Conductual Menonita-CimaCCN 404009 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Part of
Centro de Salud Conductual Menonita Cima

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lymari Colon Colon Individual W-2 Managing EmployeeChief Financial Officer Jan 29, 2021 25%
Lissette Vasquez Rivera Individual Corporate Director Jan 1, 2024 5%
W-2 Managing EmployeeDirector of Collection Jan 1, 2024 5%
Jose Solivan Rivera Individual Corporate DirectorAssociate Ceo Jan 29, 2021 25%
Luis Melendez Cintron Individual W-2 Managing EmployeeAdministrator Jan 29, 2021 25%
Ricardo Hernandez Rivera Individual Corporate OfficerCeo Jan 29, 2021 25%

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1487371399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1650",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007391650",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BOULEVARD DEL RIO OFFICE BUILDING A-3",
            "address_2": "RAMAL 3, BO CTANO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007910073",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENNONITE GENERAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MENNONITE GENERAL HOSPITAL INC",
        "enumeration_date": "2022-10-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ RIVERA",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-434-1700"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA OPERACIONAL",
            "identifier": "6",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvazquez@mghpr.org",
            "affiliation": "N",
            "endpointDescription": "lvazquez@mghpr.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lvazquez@mghpr.org",
            "address_1": "Boulevard Del Rio Office Building A-3",
            "address_2": "ramal 3, Bo Ctano",
            "city": "Humacao",
            "state": "PR",
            "country_code": "US",
            "postal_code": "007910073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Centro de Salud Conductual Menonita CIMA-Humacao",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centro de Salud Conductual Menonita CIMA-Humacao",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.