| Cherry Street Services, Inc. | |
|
2135 Buchanan Ave Sw Grand Rapids MI 49507-2911 | |
| (616) 247-3638 | |
| (616) 247-0780 |
| Full Name | Cherry Street Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2135 Buchanan Ave Sw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Tasha Blackmon (CEO) |
| Authorized Official Contact | 6169658215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cherry Street Services, Inc. 100 Cherry St Se Grand Rapids MI 49503-4526 Ph: (616) 965-8200 | Cherry Street Services, Inc. 2135 Buchanan Ave Sw Grand Rapids MI 49507-2911 Ph: (616) 247-3638 |
| NPI Number | 1770656605 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 08/25/2023 |
| Medicare PECOS PAC ID | 6800707647 |
|---|---|
| Medicare Enrollment ID | O20100818000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770656605 | NPI | - | NPPES |
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