Organization
BRENAI SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON NICHOLS (CEO/QUALIFIED PROFESSIONAL)
(980) 229-1269
Entity
Organization
Contact information
Practice address
3719 COLEMAN DR, CHARLOTTE, NC 28215-9529
(980) 229-1269
Mailing address
PO BOX 560151, CHARLOTTE, NC 28256-0151
(980) 229-1269
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BREN
—
NC
Enumeration date
05/25/2026
Last updated
05/25/2026
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