# THI OF NEVADA AT VEGAS VALLEY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Nevada Medical and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235330242
- **Authorized official:** EDMOND MORACHE (PRESIDENT)
- **Authorized official phone:** (702) 735-7179

## Contact information

- **Practice address:** 2945 CASA VEGAS ST, LAS VEGAS, NV 89109-2248
- **Practice address phone:** (702) 735-7179
- **Mailing address:** 920 RIDGEBROOK RD, SPARKS, MD 21152-9390
- **Mailing address phone:** (410) 773-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1214SNF16 | NV | Yes |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 08/22/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100506701 | — | NV |