| Cherry Street Services, Inc | |
|
50 35th St Sw Grand Rapids MI 49548-2100 | |
| (616) 965-8200 | |
| Not Available |
| Full Name | Cherry Street Services, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 50 35th St Sw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Tasha Blackmon (CEO) |
| Authorized Official Contact | 6169658200 |
| 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) 965-8209 | Cherry Street Services, Inc 50 35th St Sw Grand Rapids MI 49548-2100 Ph: (616) 965-8200 |
| NPI Number | 1609555218 |
|---|---|
| Provider Enumeration Date | 07/12/2023 |
| Last Update Date | 07/12/2023 |
| Certification Date | 07/07/2023 |
| Medicare PECOS PAC ID | 6800707647 |
|---|---|
| Medicare Enrollment ID | O20230927001593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609555218 | NPI | - | NPPES |
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