CHERRY STREET SERVICES INC NPI 1902024649

NPI Information

NPI: 1902024649
Provider Name: CHERRY STREET SERVICES, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
100 CHERRY ST SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 776-2120
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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 1902024649. The provider is registered as an organization entity type.

The provider's business location address is:

100 CHERRY ST SE
GRAND RAPIDS, MI
ZIP 49503-526
Phone: (616) 776-2120
Fax: (616) 776-2122

The provider's authorized official is Chris Shea .
The authorized official title is Ceo and has the following contact phone number (616) 776-2120.

The enumeration date for this NPI number is 4/20/2007 and was last updated on 2/2/2015.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	=========	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	MICHIGAN	TAX IDENTIFICATION NUMBER

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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