Organization
CHERRY STREET SERVICES, INC.
Active
Parent organization
CHERRY STREET SERVICES, INC.
Other names
School Dental Program
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
550 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 235-7272
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/30/2008
Last updated
01/09/2026
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