Healthcare Provider Details

I. General information

NPI: 1417876632
Provider Name (Legal Business Name): BRET MAINS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COUNTRY PINE LN
BATTLE CREEK MI
49015-4191
US

IV. Provider business mailing address

100 COUNTRY PINE LN
BATTLE CREEK MI
49015-4191
US

V. Phone/Fax

Practice location:
  • Phone: 810-321-3019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: