SOUTHSIDE HEALTH CENTER
NPI 1386926004
Clinic/Center - Federally Qualified Health Center (FQHC) in Grand Rapids, MI

Q: What is Cherry Street Services Inc's NPI number?

The NPI number for Cherry Street Services Inc is 1386926004. It was assigned to this organization in the NPPES registry on September 20, 2011. The provider is doing business as Southside Health Center.

Q: What is Cherry Street Services Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since September 20, 2011CLIA Certified · 2 labs

2303 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49507(616) 965-8390(616) 254-8192 Get Directions Write a Review

NPPES record last updated: August 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 25, 2023, Dec 29, 2021 (2 updates tracked since 2021).

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About Southside Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSIDE HEALTH CENTER (NPI 1386926004) is a healthcare organization registered as a federally qualified health center (fqhc) in Grand Rapids, Michigan and active in the NPI registry since September 2011. The organization holds 2 active CLIA laboratory certificates and lists Tasha Blackmon, Ceo, as its authorized official.

NPPES Registry Identity

NPI1386926004

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameCHERRY STREET SERVICES INC

Location Address2303 KALAMAZOO AVE SEGrand Rapids, MI 49507-3780

Mailing Address100 Cherry St SeGrand Rapids, MI 49503-4526 · (616) 965-8200

Phone(616) 965-8390

Fax(616) 254-8192

Organization SubpartYes

Authorized OfficialTasha BlackmonCeo · (616) 965-8215

Enumeration DateSeptember 20, 2011

Last NPPES UpdateAugust 25, 20232 updates tracked since enumeration

NPPES CertifiedAugust 25, 2023

✔ NPI 1386926004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedRegistered NurseTaxonomy 163W00000X

Also ListedAnesthesiology · Addiction MedicineTaxonomy 207LA0401X

2303 KALAMAZOO AVE SE, Grand Rapids, MI 49507

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Other Names 1

Doing Business AsSouthside Health Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2036900

Southside Health Center · Grand Rapids, MI

Active · expires Jun 8, 2027

CLIA Number23D2036900

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateJune 9, 2025

Certificate Expiration DateJune 8, 2027

Laboratory DirectorJenny L. Bush

Laboratory Phone(616) 965-8200

Laboratory LocationSouthside Health Center2303 Kalamazoo Ave SE, Grand Rapids, MI 49507

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D2235578

Southside Health Center Suite 200 · Grand Rapids, MI

Active · expires Jun 8, 2027

CLIA Number23D2235578

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateJune 9, 2025

Certificate Expiration DateJune 8, 2027

Laboratory DirectorRhonda Mejeur

Laboratory Phone(616) 965-8200

Laboratory LocationSouthside Health Center Suite 2002303 Kalamazoo Avenue S E Suite 200, Grand Rapids, MI 49507

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm G2067

Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.

1,073 services39 patients

Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure G2078

This service provides an additional 7-day supply of methadone, a medication used to treat opioid addiction, for patients to take at home. It's provided by a Medicare-enrolled opioid treatment program. This service is billed separately from the main treatment procedure.

256 services26 patients

Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for G2077

Periodic assessment is a routine check-up by trained professionals to determine the best mix of services and treatments for your health needs. This is typically provided by a Medicare-enrolled opioid treatment program. It's listed separately in addition to your main treatment code. This ensures you receive the most suitable care for your situation.

146 services37 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAVONNE JENNELL FOSTER LMSW

Social Worker