Organization
THI OF NEVADA AT VEGAS VALLEY, LLC
Active
Other names
Southern Nevada Medical and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDMOND MORACHE (PRESIDENT)
(702) 735-7179
Entity
Organization
Contact information
Practice address
2945 CASA VEGAS ST, LAS VEGAS, NV 89109-2248
(702) 735-7179
Mailing address
920 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1214SNF16
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506701
—
NV
Enumeration date
05/29/2007
Last updated
08/22/2011
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