Organization
CHERRY STREET SERVICES, INC.
Active
Other names
School Based Program Medical
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SHEA (CEO)
(616) 776-2120
Entity
Organization
Contact information
Practice address
550 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 235-7272
(616) 235-7605
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
MI
207Q00000X
Family Medicine Physician
Primary
2800317
MI
Other
Enumeration date
01/02/2007
Last updated
10/19/2012
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