Organization
BELOVED COMMUNITY FAMILY WELLNESS CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGIE JOHNSON (EXECUTIVE DIRECTOR)
(773) 651-3629
Entity
Organization
Contact information
Practice address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 651-3629
(773) 322-1599
Mailing address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 651-3629
(773) 322-1599
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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