Organization
CHERRY STREET SERVICES, INC.
Active
Organization
CHERRY STREET SERVICES, INC.
Active
Other names
Ottawa Hills High School Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA BLACKMON (CEO)
(616) 965-8215
Entity
Organization
Contact information
Practice address
2055 ROSEWOOD AVE SE, GRAND RAPIDS, MI 49506-5248
(616) 776-5110
(616) 776-5111
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
MI
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
08/25/2023
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