Organization
CHERRY STREET SERVICES, INC.
Active
Organization
CHERRY STREET SERVICES, INC.
Active
Other names
Westside Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA BLACKMON (CEO)
(616) 965-8200
Entity
Organization
Contact information
Practice address
669 STOCKING AVE NW, GRAND RAPIDS, MI 49504-5176
(616) 235-1480
(616) 458-8102
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
104100000X
Social Worker
—
MI
122300000X
Dentist
—
—
133N00000X
Nutritionist
—
MI
163W00000X
Registered Nurse
—
MI
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
05/07/2018
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