Provider Demographics
NPI:1093942617
Name:MENNONITE GENERAL HOSPITAL INC
Entity Type:Organization
Organization Name:MENNONITE GENERAL HOSPITAL INC
Other - Org Name:CENTRO DE SALUD CONDUCTUAL MENONITA-CIMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:B
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:OTHER
Authorized Official - Phone:787-714-2462
Mailing Address - Street 1:CIMA
Mailing Address - Street 2:PO BOX 1379
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1379
Mailing Address - Country:US
Mailing Address - Phone:787-714-2462
Mailing Address - Fax:787-735-3233
Practice Address - Street 1:CARRETERA ESTATAL 14 INTERIOR
Practice Address - Street 2:CALLE SARGENTO GERARDO SANTIAGO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-1379
Practice Address - Country:US
Practice Address - Phone:787-714-2462
Practice Address - Fax:787-735-3233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENNONITE GENERAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-22
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital