Organization
CHERRY STREET SERVICES INC
Active
Organization
CHERRY STREET SERVICES INC
Active
Other names
Montcalm Area Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TASHA BLACKMON (EXECUTIVE DIRECTOR)
(616) 965-8200
Entity
Organization
Contact information
Practice address
1003 N LAFAYETTE ST, GREENVILLE, MI 48838-1168
(616) 225-9650
(616) 225-8525
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
—
—
152W00000X
Optometrist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/09/2007
Last updated
12/29/2021
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