Healthcare Provider Details

I. General information

NPI: 1114891249
Provider Name (Legal Business Name): SMART MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2774 BIRCHCREST DR SE
GRAND RAPIDS MI
49506-5477
US

IV. Provider business mailing address

2774 BIRCHCREST DR SE
GRAND RAPIDS MI
49506-5477
US

V. Phone/Fax

Practice location:
  • Phone: 616-988-3422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SANA SARWAR
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential:
Phone: 419-508-4133