Provider Demographics
NPI:1093958043
Name:C L BUSH AND ASSOCIATES, INC
Entity Type:Organization
Organization Name:C L BUSH AND ASSOCIATES, INC
Other - Org Name:PREMIER SOLUTIONS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CADORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, C
Authorized Official - Phone:248-545-8787
Mailing Address - Street 1:22750 WOODWARD AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1754
Mailing Address - Country:US
Mailing Address - Phone:248-545-8787
Mailing Address - Fax:248-545-8789
Practice Address - Street 1:22750 WOODWARD AVE STE 309
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1754
Practice Address - Country:US
Practice Address - Phone:248-545-8787
Practice Address - Fax:248-545-8789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704131505251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health