Organization
BLUEBIRD SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY GREY (OWNER)
(208) 691-5925
Entity
Organization
Contact information
Practice address
1322 N WHITLEY DR, FRUITLAND, ID 83619-2234
(208) 691-5925
Mailing address
1322 N WHITLEY DR, FRUITLAND, ID 83619-2234
(208) 691-5925
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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