Provider Demographics
NPI:1508410291
Name:CHERRY PROFESSIONAL SERVICES INC
Entity Type:Organization
Organization Name:CHERRY PROFESSIONAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-385-6143
Mailing Address - Street 1:216 N GLENDORA AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-6924
Mailing Address - Country:US
Mailing Address - Phone:626-385-6143
Mailing Address - Fax:626-691-6189
Practice Address - Street 1:216 N GLENDORA AVE STE 205
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-6924
Practice Address - Country:US
Practice Address - Phone:626-385-6143
Practice Address - Fax:626-691-6189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)