CHERRY STREET SERVICES INC (NPI# 1265081418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265081418 |
| Entity Type | Organization |
| Organization Name | CHERRY STREET SERVICES INC |
| Other Organization Name | WYOMING JUNIOR HIGH SCHOOL HEALTH CENTER |
| Practice Address |
2125 Wrenwood St Sw Ofc Therapist Wyoming MI 49519-2362 |
| Mailing Address |
100 Cherry St Se Grand Rapids MI 49503-4526 |
| Practice Telephone | 6165307590 |
| Practice Fax Number | 6162497673 |
| Mailing Telephone | 6169658200 |
| Mailing Fax Number | 6169405366 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2020-03-25 |
| Authorized Official Name | LINDA M CONSTANTINO (CFO) |
| Authorized Official Telephone | 6167762128 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHERRY STREET SERVICES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Wyoming Junior High School Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104423508 | Cherry Street Services Inc | Community/Behavioral Health | 100 Wexford St Se Rm 214, Wyoming, MI 49548-2212 | 2020-10-08 |
| 1184974263 | Cherry Street Services Inc | Counselor | 2929 Burlingame Ave Sw, Wyoming, MI 49509-2609 | 2012-09-14 |
| 1346600905 | Cherry Street Services Inc | Clinic/Center | 1611 Oak Ave, Muskegon, MI 49442-2468 | 2016-02-25 |
| 1427438944 | Cherry Street Services Inc | Clinic/Center | 1033 Healthcare Dr, Charlotte, MI 48813-1058 | 2015-06-01 |
| 1184015539 | Cherry Street Services Inc | Clinic/Center | 204 E Muskegon St, Cedar Springs, MI 49319-9326 | 2015-02-06 |
| 1962800680 | Cherry Street Services Inc | Dentist | 1230 W State St, Hastings, MI 49058-9712 | 2014-12-11 |
| 1316340094 | Cherry Street Services Inc | Social Worker | 421 Fountain St Ne, Grand Rapids, MI 49503-3334 | 2014-10-08 |
| 1801298716 | Cherry Street Services Inc | Counselor | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2014-09-23 |
| 1396165601 | Cherry Street Services Inc | Dentist | 100 Cherry Street, Grand Rapids, MI 49503 | 2014-04-25 |
| 1265862841 | Cherry Street Services Inc | Social Worker | 330 W Woodlawn Ave, Hastings, MI 49058-1035 | 2013-11-19 |
| Street Address |
2125 WRENWOOD ST SW OFC THERAPIST |
| City | WYOMING |
| State | MI |
| Zip Code | 49519-2362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
| 1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
| 1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
| 1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
| 1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
| Find all providers in zip 49519 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1235750571 | Great Lakes Bay Health Centers | Clinic/Center | 2300 Veterans Memorial Pkwy, Saginaw, MI 48601-1268 | 2020-04-28 |
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1568096923 | Grace Health, Inc. | Clinic/Center | 825 Capital Ave Ne, Battle Creek, MI 49017-5605 | 2020-02-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.