Healthcare Provider Details

I. General information

NPI: 1548120371
Provider Name (Legal Business Name): MM PSYCHIATRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 CALLE MUNOZ RIVERA
CABO ROJO PR
00623-4060
US

IV. Provider business mailing address

PO BOX 818
CEIBA PR
00735-0818
US

V. Phone/Fax

Practice location:
  • Phone: 787-716-9137
  • Fax:
Mailing address:
  • Phone: 787-716-9137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: KEYLA CENTENO
Title or Position: PRESIDENT
Credential: MBR
Phone: 787-716-9137