Organization · Type 2 NPI
Cherry Street Services Inc
Federally Qualified Health Center (FQHC) · Wyoming, MI
NPI number
1104423508
Active
Practice location
100 Wexford St SE Rm 214
Wyoming, MI 49548-2212
Mailing address
100 Cherry St SE
Grand Rapids, MI 49503-4526
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
| Medical Specialty Clinic/Center | 261QM2500X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
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About NPI 1104423508
Cherry Street Services Inc's National Provider Identifier is 1104423508, issued on Oct 8, 2020. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Wyoming, MI. The record was last updated on Aug 25, 2023.