Healthcare Provider Details

I. General information

NPI: 1205780632
Provider Name (Legal Business Name): DELGADO INDEPENDENT SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3317 DEVONSHIRE LN
PUEBLO CO
81005-3213
US

IV. Provider business mailing address

3430 PECAN DR
PUEBLO CO
81005-2855
US

V. Phone/Fax

Practice location:
  • Phone: 719-320-3658
  • Fax:
Mailing address:
  • Phone: 719-320-3658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RAUL DELGADO
Title or Position: CEO
Credential:
Phone: 719-320-3658