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BLUEBIRD HOSPICE, LLC

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Company Details

Name: BLUEBIRD HOSPICE, LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 03 Jun 2020 (5 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 3888958
Place of Formation: DELAWARE
File Number: 712018
ZIP code: 83642
County: Ada County
Principal Address: STE 203 3080 GENTRY WAY MERIDIAN, ID 83642
Mailing Address: STE 150 1675 E RIVERSIDE DR EAGLE, ID 83616-7584

Agent

Name Role Address
UNIVERSAL REGISTERED AGENTS, INC. Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

Member

Name Role Address Appointed On
Elevate HC Partners, LLC Member 1675 E RIVERSIDE DR, EAGLE, ID 83616-7584 2021-06-18

Manager

Name Role Address Appointed On Resigned On
Brian Wayment Manager 1675 E RIVERSIDE DR, EAGLE, ID 83616-7584 2023-06-20 2024-06-26
John Gochnour Manager 1675 E. RIVERSIDE DR., EAGLE, ID 83616 2024-06-26 No data

Governor

Name Role Address Appointed On
Nikolas Hulewsky Governor 2205 E RIVERSIDE DRIVE, EAGLE, ID 83616 2023-03-27

National Provider Identifier

NPI Number:
1104441963
Certification Date:
2025-05-28

Authorized Person:

Name:
AMBER L TUELLER
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
251G00000X - Community Based Hospice Care Agency
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006288148 2025-05-29
Annual Report 0006262381 2025-05-21
Annual Report 0005789562 2024-06-26
Annual Report 0005288362 2023-06-20
Amendment of Foreign Registration Statement 0005151743 2023-03-27

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Date of last update: 07 Jul 2025

Sources: Idaho Secretary of State