Organization
BELOVED COMMUNITY FAMILY WELLNESS CENTER
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
Mailing address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
25812
IL
251S00000X
Community/Behavioral Health Agency
31898
IL
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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