# BELOVED COMMUNITY FAMILY WELLNESS CTR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891123832
- **Authorized official:** MS. ASSENATH NAAMAN LDN (DIETICIAN)
- **Authorized official phone:** (773) 651-3629

## Contact information

- **Practice address:** 6821 S HALSTED ST, CHICAGO, IL 60621-1833
- **Practice address phone:** (773) 651-3629
- **Practice address fax:** (773) 322-1599
- **Mailing address:** 6821 S HALSTED STREET, CHICAGO, IL 60621
- **Mailing address phone:** (773) 651-3629
- **Mailing address fax:** (773) 322-1599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 136A00000X | Registered Dietetic Technician | 86034476 | IL | Yes |

## Other

- **Enumeration date:** 10/30/2013
- **Last updated:** 10/30/2013