Healthcare Provider Details

I. General information

NPI: 1194664482
Provider Name (Legal Business Name): GOLDEN TIMES HOME AWAY FROM HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 MARSH POINTE DR
COLUMBIA SC
29229-7025
US

IV. Provider business mailing address

476 MARSH POINTE DR
COLUMBIA SC
29229-7025
US

V. Phone/Fax

Practice location:
  • Phone: 843-609-7855
  • Fax:
Mailing address:
  • Phone: 843-609-7855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MILDRED RENEE BROWN
Title or Position: OWNER
Credential:
Phone: 843-609-7855