Organization
CHERRY STREET SERVICES INC
Active
Parent organization
CHERRY STREET SERVICES INC
Other names
Wyoming Junior High School Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHERRY STREET SERVICES INC
Authorized official
TASHA BLACKMON (CEO)
(616) 965-8215
Entity
Organization
Contact information
Practice address
2125 WRENWOOD ST SW OFC THERAPIST, WYOMING, MI 49519-2362
(616) 530-7590
(616) 249-7673
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
09/10/2019
Last updated
08/25/2023
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