CHERRY STREET SERVICES INC NPI 1982279428

NPI Information

  • NPI: 1982279428
  • Provider Name: CHERRY STREET SERVICES INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: CHERRY HEALTH - SOUTHSIDE HEALTH CENTER SUITE 200
  • Address: 2303 KALAMAZOO AVE SE STE 200
    GRAND RAPIDS, MI
    ZIP 49507
  • Phone: (616) 965-8379

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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 1982279428. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cherry Health - Southside Health Center Suite 200.

The provider's business location address is:

2303 KALAMAZOO AVE SE STE 200
GRAND RAPIDS, MI
ZIP 49507-780
Phone: (616) 965-8379
Fax: (616) 940-5354

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 enumeration date for this NPI number is 5/26/2021 and was last updated on 8/31/2021.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2207P00000XEmergency MedicineNo
3207Q00000XFamily MedicineNo
4103TA0400XPsychologistAddiction (Substance Use Disorder)No
51041C0700XSocial WorkerClinicalNo
6207L00000XAnesthesiologyNo
7207LA0401XAnesthesiologyAddiction MedicineNo
8207R00000XInternal MedicineNo
9261QF0400XClinic/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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