NPIMap

Organization Active NPI

Wicker Basket LLC

  • Alzheimer Center (Dementia Center)
  • North Las Vegas, NV
National Provider Identifier
1073006706
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
Legal business name
WICKER BASKET LLC
Practice address
3020 Beaufort CT
North Las Vegas, NV 89032-0478
Phone
(702) 994-0857
NPI assigned
Jun 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lourdes Manguino
Title
Ownwe
Phone
(702) 445-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X Primary

Addresses

Primary practice location

3020 Beaufort CT
North Las Vegas, NV 89032-0478

Mailing address

3020 Beaufort CT
North Las Vegas, NV 89032-0478
Phone (702) 445-0088

Other names 1

  • Wicker Basket Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Helping Hands Care Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1073006706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BEAUFORT CT",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320478",
            "telephone_number": "702-445-0088",
            "fax_number": "702-476-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 BEAUFORT CT",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320478",
            "telephone_number": "702-994-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKER BASKET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "MANGUINO",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_title_or_position": "OWNWE",
        "authorized_official_telephone_number": "702-445-0088"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wicker Basket",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.