Provider Demographics
NPI:1225266059
Name:SOUTHWEST HEALTH CORP
Entity Type:Organization
Organization Name:SOUTHWEST HEALTH CORP
Other - Org Name:HOSPITAL METROPOLITANO PSIQUIATRICO DE CABO ROJO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR EJECUTIVO
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:EZEQUIEL
Authorized Official - Last Name:ORTIZ PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-851-2025
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0910
Mailing Address - Country:US
Mailing Address - Phone:787-806-1687
Mailing Address - Fax:787-806-1686
Practice Address - Street 1:AVE. GONZALEZ CLEMENTE #445, BO. GUANAJIBO
Practice Address - Street 2:EDIF. VAL HARBOR, SUITE 105
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681
Practice Address - Country:US
Practice Address - Phone:787-806-1687
Practice Address - Fax:787-806-1686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR70261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)