CHERRY STREET SERVICES INC. NPI 1891867495

NPI Information

NPI: 1891867495
Provider Name: CHERRY STREET SERVICES, INC.

Doing Business As: WESTSIDE HEALTH CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
669 STOCKING AVE NW
GRAND RAPIDS, MI
ZIP 49504
Phone: (616) 235-1480
Get Directions

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 State	Primary
1	103G00000X	Clinical Neuropsychologist			No
2	104100000X	Social Worker		MICHIGAN	No
3	122300000X	Dentist			No
4	133N00000X	Nutritionist		MICHIGAN	No
5	163W00000X	Registered Nurse		MICHIGAN	No
6	207Q00000X	Family Medicine			No
7	208000000X	Pediatrics			No
8	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: 11/14/2023

NPI Synchronization or Removal

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