Organization
BELOVED COMMUNITY FAMILY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGIE NEDA JOHNSON MS (EXECUTIVE DIRECTOR)
(773) 651-3828
Entity
Organization
Contact information
Practice address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 651-3629
(773) 651-1599
Mailing address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 651-3629
(773) 322-1955
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
036113305
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/01/2011
Last updated
08/24/2017
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