Provider Demographics
NPI:1235002734
Name:PROMIND LLC
Entity type:Organization
Organization Name:PROMIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-882-1458
Mailing Address - Street 1:1257 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1346
Mailing Address - Country:US
Mailing Address - Phone:810-882-1458
Mailing Address - Fax:754-218-0872
Practice Address - Street 1:5234 CREEKMONTE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-4794
Practice Address - Country:US
Practice Address - Phone:810-882-1458
Practice Address - Fax:754-218-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty