CHERRY STREET SERVICES INC. NPI 1891867495

NPI Information

  • NPI: 1891867495
  • Provider Name: CHERRY STREET SERVICES, INC.
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: WESTSIDE HEALTH CENTER
  • CLIA Number: 23D0959092
  • Address: 669 STOCKING AVE NW
    GRAND RAPIDS, MI
    ZIP 49504
  • Phone: (616) 235-1480

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NPI Details

CHERRY STREET SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Grand Rapids, MI. CHERRY STREET SERVICES, INC. NPI is 1891867495. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Westside Health Center.

The provider's business location address is:

669 STOCKING AVE NW
GRAND RAPIDS, MI
ZIP 49504-176
Phone: (616) 235-1480
Fax: (616) 458-8102

The provider's authorized official is Tasha Blackmon .
The authorized official title is Ceo and has the following contact phone number (616) 965-8200.

The CLIA number assigned to this NPI record is 23D0959092 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/15/2006 and was last updated on 5/7/2018.

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
1103G00000XClinical NeuropsychologistNo
2104100000XSocial WorkerMICHIGANNo
3122300000XDentistNo
4133N00000XNutritionistMICHIGANNo
5163W00000XRegistered NurseMICHIGANNo
6207Q00000XFamily MedicineNo
7208000000XPediatricsNo
8261QF0400XClinic/CenterFederally 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: 11/21/2025

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