Organization · Type 2 NPI

Cherry Street Services, Inc.

Federally Qualified Health Center (FQHC) · Grand Rapids, MI

NPI number 1124187471 Active

Practice location

2055 Rosewood Ave SE
Grand Rapids, MI 49506-5248

Call (616) 776-5110 Map

Fax (616) 776-5111

Mailing address

100 Cherry St SE
Grand Rapids, MI 49503-4526

Specialties and licenses

Taxonomy	Code	License
Social Worker	104100000X	None listed
Dentist	122300000X	None listed
Family Medicine Physician	207Q00000X	None listed
Pediatrics Physician	208000000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Sanka Divic, RDHDental Hygienist Grand Rapids, MI NPI 1679946263

Other federally qualified health center (fqhc) providers in Grand Rapids

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NPI record

NPI: 1124187471
Entity type: Organization (Type 2)
Issued: Dec 6, 2006
Last updated: Aug 25, 2023
Status: Active

Other names

<unavail>
Ottawa Hills High School Health Center · doing business as
Ottawa Hills High School Health Center · doing business as

Authorized official

Tasha Blackmon
CEO
(616) 965-8215

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124187471

Cherry Street Services, Inc.'s National Provider Identifier is 1124187471, issued on Dec 6, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Grand Rapids, MI. The record was last updated on Aug 25, 2023.