Organization
A TIME FOR HEART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON BUETSCH (OWNER)
(815) 518-8633
Entity
Organization
Contact information
Practice address
3013 15TH ST, C/O SHANNON BUETSCH, ROCKFORD, IL 61109-1313
(815) 581-8633
Mailing address
3013 15TH ST, C/O SHANNON BUETSCH, ROCKFORD, IL 61109-1313
(815) 581-8633
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374700000X
Technician
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/21/2024
Last updated
10/29/2024
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