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Organization

CHERRY STREET SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRIS SHEA (CEO)
(616) 776-2129
Entity
Organization

Contact information

Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103T00000X
Psychologist
104100000X
Social Worker
122300000X
Dentist
124Q00000X
Dental Hygienist
152W00000X
Optometrist
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
2084N0400X
Neurology Physician
208D00000X
General Practice Physician
Primary

Other

Enumeration date
09/23/2014
Last updated
09/23/2014
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