Organization
CHERRY STREET SERVICES, INC
Active
Parent organization
CHERRY STREET SERVICES, INC.
Other names
Barry Community Health Center, Cherry Health - Barry Community Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHERRY STREET SERVICES, INC.
Authorized official
TASHA BLACKMON (CHIEF EXECUTIVE OFFICER)
(616) 965-8215
Entity
Organization
Contact information
Practice address
200 S BOLTWOOD ST, HASTINGS, MI 49058
(269) 945-4220
(269) 945-4229
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8209
(269) 945-4229
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
163W00000X
Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
08/25/2023
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