Organization
TED HERNANDEZ INC
Active
Other names
Spectrum Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE HERNANDEZ (OWNER)
(719) 545-4057
Entity
Organization
Contact information
Practice address
105 LEHIGH AVE, PUEBLO, CO 81005-1855
(719) 545-4057
Mailing address
105 LEHIGH AVE, PUEBLO, CO 81005-1855
(719) 545-4057
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15431061
—
CO
Enumeration date
10/27/2015
Last updated
02/13/2017
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