CHERRY STREET SERVICES INC. NPI 1982764643

NPI Information

NPI: 1982764643
Provider Name: CHERRY STREET SERVICES, INC.

Doing Business As: UNION HIGH SCHOOL HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1800 TREMONT BLVD NW
GRAND RAPIDS, MI
ZIP 49504
Phone: (616) 791-6593
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CHERRY STREET SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Grand Rapids, MI. CHERRY STREET SERVICES, INC. NPI is 1982764643. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Union High School Health Center.

The provider's business location address is:

1800 TREMONT BLVD NW
GRAND RAPIDS, MI
ZIP 49504-868
Phone: (616) 791-6593
Fax: (616) 791-6729

The provider's authorized official is Tasha Blackmon .
The authorized official title is Ceo and has the following contact phone number (616) 965-8215.

The CLIA number assigned to this NPI record is 23D0977021 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 8/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	104100000X	Social Worker			MICHIGAN	No
2	122300000X	Dentist				No
3	207Q00000X	Family Medicine		4301056818	MICHIGAN	No
4	208000000X	Pediatrics		4301082271	MICHIGAN	No
5	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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