Ted Hernandez Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

TED HERNANDEZ INC

Doing business as

Spectrum Community Services

Practice address

105 Lehigh Ave
Pueblo, CO 81005-1855

Phone

(719) 545-4057

NPI assigned

Oct 27, 2015

Last updated

Feb 13, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Theodore Hernandez

Title

Owner

Phone

(719) 545-4057

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Spectrum Community Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1447622634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LEHIGH AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051855",
            "telephone_number": "719-545-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LEHIGH AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051855",
            "telephone_number": "719-545-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED HERNANDEZ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-545-4057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15431061",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Ann Taylor
• Tori Taylor, CRNA
• Teamselect Home Care of Colorado, LLC (Team Select Home Care)
• Teamselect Home Care of Colorado, LLC (Team Select Home Care)
• Laci Paige Tecklenburg, COTA
• Ted J Puls MD PC
• Detorrion Temple
• Teresa Koppin
• Larry Edward Terrell, CAC III
• Veronica Terrones, RN

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.