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General NPI Number Information
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NPI Number | 1912728197
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Entity Type | Organization
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Legal Business Name | A TIME FOR HEART
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 3013 15TH ST C/O SHANNON BUETSCH
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City | ROCKFORD
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State | IL
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Zip | 61109-1313
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Country | US
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Telephone | 815-581-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 15TH ST C/O SHANNON BUETSCH
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City | ROCKFORD
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State | IL
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Zip | 61109-1313
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Country | US
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Telephone | 815-581-8633
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHANNON BUETSCH
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Credential |
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Telephone | 815-518-8633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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