Organization
CHERRY STREET SERVICES, INC.
Active
Other names
Creston High School Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SHEA (CEO)
(616) 776-2120
Entity
Organization
Contact information
Practice address
1720 PLAINFIELD NW, GRAND RAPIDS, MI 49505-4705
(616) 776-5120
(616) 776-5121
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
MI
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
Primary
4301056818
MI
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
12/12/2006
Last updated
02/14/2013
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