TED HERNANDEZ INC NPI 1447622634

NPI Information

NPI: 1447622634
Provider Name: TED HERNANDEZ INC

Doing Business As: SPECTRUM COMMUNITY SERVICES

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
105 LEHIGH AVE
PUEBLO, CO
ZIP 81005
Phone: (719) 545-4057
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TED HERNANDEZ INC is a community based residential treatment facility, intellectual and/or developmental disabilities in Pueblo, CO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. TED HERNANDEZ INC NPI is 1447622634. The provider is registered as an organization entity type.
The provider Is Doing Business As Spectrum Community Services.

The provider's business location address is:

105 LEHIGH AVE
PUEBLO, CO
ZIP 81005-855
Phone: (719) 545-4057

The provider's authorized official is Theodore Hernandez .
The authorized official title is Owner and has the following contact phone number (719) 545-4057.

The enumeration date for this NPI number is 10/27/2015 and was last updated on 2/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	251C00000X	Day Training, Developmentally Disabled Services	No
2	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Yes
3	376J00000X	Homemaker	No
4	385H00000X	Respite Care	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	15431061	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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