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Organization

CHERRY STREET SERVICES, INC

Active
Parent organization
CHERRY STREET SERVICES, INC
Other names
Godwin Heights Senior High School Health Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHERRY STREET SERVICES, INC
Authorized official
TASHA BLACKMON (CEO)
(616) 965-8200
Entity
Organization

Contact information

Practice address
50 35TH ST SW, GRAND RAPIDS, MI 49548-2100
(616) 965-8200
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8209
(616) 940-5366

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YS0200X
School Counselor
104100000X
Social Worker
1041C0700X
Clinical Social Worker
1041S0200X
School Social Worker
122300000X
Dentist
124Q00000X
Dental Hygienist
125J00000X
Dental Therapist
126800000X
Dental Assistant
133V00000X
Registered Dietitian
152W00000X
Optometrist
163WS0200X
School Registered Nurse
207Q00000X
Family Medicine Physician
208000000X
Pediatrics Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
07/12/2023
Last updated
07/12/2023
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