MEDICARE: SAN JUAN CAPESTRANO HOSPITAL, INC.

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)	55	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10934	OTHER	PR	SSS

General Provider Information

NPI Number	:	1770794745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JUAN CAPESTRANO HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	4020 ASPEN GROVE DR STE 900
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-3134
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	RAMAL 506 ESQUINA AVE, FLAMBOYAN CARR 14
Second Line	:	COTO LAUREL WARD
City	:	PONCE
State	:	PR
Zip	:	00780
Country	:	US
Telephone Number	:	787-842-4070
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT & SECRETARY
Name	:	BRIAN P. FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	01/20/2026

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