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Organization

THI OF SOUTH CAROLINA GOLDEN AGE AT INMAN, LLC

Active
Other names
Golden Age - Inman
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY JOHNSON (PRESIDENT)
(864) 472-6636
Entity
Organization

Contact information

Practice address
82 N MAIN ST, INMAN, SC 29349-1416
(864) 472-6636
(864) 472-6524
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0857NF
SC
Enumeration date
10/07/2006
Last updated
04/07/2008
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