Healthcare Provider Details

I. General information

NPI: 1588589055
Provider Name (Legal Business Name): BCG DYNAMICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9252 IVES ST
BELLFLOWER CA
90706-3516
US

IV. Provider business mailing address

9252 IVES ST
BELLFLOWER CA
90706-3516
US

V. Phone/Fax

Practice location:
  • Phone: 562-455-7981
  • Fax:
Mailing address:
  • Phone: 562-455-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BERENICE G CRISTERNA
Title or Position: MANAGER
Credential:
Phone: 562-455-7981