Wicker Basket LLC
NPI #1073006706 in North Las Vegas, Nevada
Provider Information
- NPI Number
- 1073006706
- Entity Type
- Organization
- Organization Name
- Wicker Basket LLC
- Primary Specialty
- Alzheimer Center (Dementia Center)
- Enumeration Date
- Jun 7, 2018
- Last Updated
- Oct 15, 2020
Practice Location
- Address
- 3020 BEAUFORT CT
- City
- North Las Vegas
- State
- Nevada
- ZIP Code
- 89032-0478
- Phone
- (702) 994-0857
Authorized Official
- Name
- LOURDES MANGUINO
- Title
- OWNWE
- Phone
- (702) 445-0088
Specialties & Taxonomy Codes
| Specialty |
|---|
| Alzheimer Center (Dementia Center) |
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