OrganizationActive
Bluebird Support Services LLC
NPI 1538036538 · Developmental - Behavioral Pediatrics Physician · Fruitland, ID
Provider details
- NPI number
- 1538036538
- Entity type
- Organization
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cody Grey, Owner(208) 691-5925
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1322 N Whitley Dr
Fruitland, ID 83619-2234
Phone: (208) 691-5925
Approximate (ZIP-level) locationGet directions
Mailing address
1322 N Whitley Dr
Fruitland, ID 83619-2234
Registry dates
- Enumerated
- 2025-10-22
- Last updated
- 2025-10-22
- Certified
- 2025-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.