MEDICARE: CENTRO DE SALUD CONDUCTUAL MENONITA CIMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1629528856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRO DE SALUD CONDUCTUAL MENONITA CIMA

Provider Business Mailing Address
First Line	:	PO BOX 1650
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739-1650
Country	:	US
Telephone Number	:	787-434-1700
Fax Number	:	787-434-1714

Provider Business Practice Location Address
First Line	:	CALLE ANTONIO R. BARCELO
Second Line	:	EDIFICIO JOSE 'PICULIN'ORTIZ ROJAS NIVEL 2 LOCAL 213
City	:	CAYEY
State	:	PR
Zip	:	00736
Country	:	US
Telephone Number	:	787-434-1700
Fax Number	:	787-434-1714

Authorized Official
Title or Position	:	BILLING MANANGER
Name	:	LISSETTE VAZQUEZ RIVERA
Credential	:
Telephone Number	:	787-434-1700

Provider Enumeration Date	:	10/12/2016
Last Update Date	:	12/22/2025

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