NPIMap

Organization Active NPI

Mennonite General Hospital Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Caguas, PR
National Provider Identifier
1699224337
Registry record updated Oct 30, 2024
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.
Practice address
Avenida Jose Gautier Benitez, Numero 230 Bo. Pueblo
Caguas, PR 00725-0000
Phone
(787) 296-9776
Fax
(787) 735-3749
NPI assigned
Sep 22, 2016
Organization subpart
Yes
Parent organization
CENTRO INTEGRAL MULTIDICIPLINARIO DE AIBONITOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Lissette Vazquez Rivera
Title
Billing Manager
Phone
(787) 434-1700

Specialties & licenses 1

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

Addresses

Primary practice location

Avenida Jose Gautier Benitez, Numero 230 Bo. Pueblo
Caguas, PR 00725-0000

Mailing address

F35 Calle 2
Urb Bonn Terrace
Caguas, PR 00725-0000
Phone (787) 434-1700

Other names 1

  • Centro de Salud Conductual Menonita CIMA- Parcial Caguas Doing business as

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

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
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
Tax ID family
Centro de Salud Conductual Menonita Cima41 organizations share this tax ID, including this one
Part of
Centro de Salud Conductual Menonita Cima

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

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 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1699224337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "F35 CALLE 2",
            "address_2": "URB BONN TERRACE",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007250000",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA JOSE GAUTIER BENITEZ, NUMERO 230 BO. PUEBLO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007250000",
            "telephone_number": "787-296-9776",
            "fax_number": "787-735-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENNONITE GENERAL HOSPITAL INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO INTEGRAL MULTIDICIPLINARIO DE AIBONITO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ RIVERA",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "787-434-1700"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centro de Salud Conductual Menonita CIMA- Parcial Caguas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.