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CHERRY STREET SERVICES INC. NPI 1982764643


NPI Information

NPI: 1982764643
Provider Name: CHERRY STREET SERVICES, INC.

Doing Business As: UNION HIGH SCHOOL HEALTH CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D0977021

Address:
1800 TREMONT BLVD NW
GRAND RAPIDS, MI
ZIP 49504
Phone: (616) 791-6593
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CHERRY STREET SERVICES, INC. is a family medicine in Grand Rapids, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CHERRY STREET SERVICES, INC. NPI is 1982764643. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Union High School Health Center.

The provider's business location address is:

1800 TREMONT BLVD NW
GRAND RAPIDS, MI
ZIP 49504-868
Phone: (616) 791-6593
Fax: (616) 791-6729

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 CLIA number assigned to this NPI record is 23D0977021 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/11/2006 and was last updated on 10/19/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1104100000XSocial WorkerMICHIGANNo
2122300000XDentistNo
3208000000XPediatrics4301082271MICHIGANNo
4207Q00000XFamily Medicine4301056818MICHIGANYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1231879MEDICARE OSCAR/CERTIFICATIONMICHIGAN

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

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