Provider Demographics
NPI:1063942472
Name:BCT, LLC
Entity type:Organization
Organization Name:BCT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DEDRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEATHERSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MED
Authorized Official - Phone:424-285-4722
Mailing Address - Street 1:1455 GALINDO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2899
Mailing Address - Country:US
Mailing Address - Phone:424-285-4722
Mailing Address - Fax:
Practice Address - Street 1:1455 GALINDO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2899
Practice Address - Country:US
Practice Address - Phone:424-285-4722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty