OrganizationActive
Cherry Street Services Inc
NPI 1043592629 · Federally Qualified Health Center (FQHC) · Grand Rapids, MI
Provider details
- NPI number
- 1043592629
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Cherry Street Services Inc
- Authorized official
- Tasha Blackmon, Executive Director
Practice location
1400 Leonard Street Ne
Grand Rapids, MI 49505-5515
Phone: (616) 954-1991
Fax: (616) 954-1998
Mailing address
100 Cherry St Se
Grand Rapids, MI 49503-4748
Registry dates
- Enumerated
- 2011-09-09
- Last updated
- 2021-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.