CHERRY STREET SERVICES INC NPI 1043592629

NPI Information

CHERRY STREET SERVICES INC is a federally qualified health center (fqhc) clinic center in Grand Rapids, MI. CHERRY STREET SERVICES INC NPI is 1043592629. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Leonard Street Counseling Center.

The provider's business location address is:

1400 LEONARD STREET NE
GRAND RAPIDS, MI
ZIP 49505-515
Phone: (616) 954-1991
Fax: (616) 954-1998

The provider's authorized official is Tasha Blackmon .
The authorized official title is Executive Director and has the following contact phone number (616) 776-2121.

The enumeration date for this NPI number is 9/9/2011 and was last updated on 10/1/2021.

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:

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