county: lexington facility type: adult day care · south carolina department of health &...

27
South Carolina Department of Health & Environmental Control Division of Health Licensing November 9, 2018 1 hlfactcc.rdf Lexington County: Adult Day Care Facility Type: HELPING HANDS ADULT DAY CARE MEMORY SUPPORTS HELPING HANDS ADULT DAY SERVICES HOPE BRIDGE AT THE HOLLIES HOPE BRIDGE AT THE OAKS LEXINGTON DAY HEALTH CENTER SC EPISCOPAL HOME AT STILL HOPES ADULT DAY CARE CUTRI KRISTEN PH#: 803-796-5192 WRIGHT BARBARA T PH#: 803-791-3256 REDDING MELODY PH#: CUTRI KRISTEN PH#: 803-796-5192 BLAND MARY JOYCE PH#: 803-939-8400 ROBERTSON NIKKI W PH#: 803-796-6490 94 92 180 165 60 12 2010 STATE ST 1111 STATE ST 2708 HEBRON RD 3532 LEAPHART RD 700 KNOX ABBOTT DR 1 STILL HOPES DR Lexington / Corporation Lexington / Corporation Lexington / Corporation Lexington / Corporation Lexington / Non-Profit Corporation Lexington / Corporation ADC-0015 / 09/30/2019 ADC-0270 / 12/31/2018 ADC-0297 / 10/31/2019 ADC-0408 / 08/31/2019 ADC-0139 / 02/28/2019 ADC-0063 / 07/31/2019 CAYCE, SC 29033-3957 FAC.#:803-223-9800 CAYCE, SC 29033-4342 FAC.#:803-223-9790 W COLUMBIA, SC 29169 FAC.#:803-791-3255 WEST COLUMBIA, SC 29169 FAC.#:803-791-3256 CAYCE, SC 29033-3340 FAC.#:803-939-8400 WEST COLUMBIA, SC 29169-7164 FAC.#:803-796-6490 2010 STATE ST 1111 STATE ST 2708 HEBRON RD 2010 STATE ST 700 KNOX ABBOTT DR PO BOX 2959 CAYCE, SC 29033-3957 CAYCE, SC 29033-4342 W COLUMBIA, SC 29169 CAYCE, SC 29033-3957 CAYCE, SC 29033-3340 WEST COLUMBIA, SC 29171-2959 Facility Name Location Street Location City, State Administrator/Phone License Nbr/Expiration Date County/Ownership Type Mailing/Billing Address Licensee Number of Participants: Number of Participants: Number of Participants: Number of Participants: Number of Participants: Number of Participants: 94 92 180 165 60 12 Number of Activities/Facilities licensed: 6 Number Licensed Units: 603 HELPING HANDS ADULT DAY CARE INC HELPING HANDS ADULT DAY CARE INC HELPING HANDS ADULT DAY CARE INC HELPING HANDS ADULT DAY CARE MEMORY SUPPORTS PALMETTO HEALTH SOUTH CAROLINA EPISCOPAL HOME AT STILL HOPES INC Totals For Facility/License Type: Adult Day Care Facility Email: Facility Email: Facility Email: Facility Email: Facility Email: Facility Email: [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] Licensed Units

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Page 1: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

1 hlfactcc.rdf

LexingtonCounty:

Adult Day CareFacility Type:

HELPING HANDS ADULT DAY CARE MEMORY SUPPORTS

HELPING HANDS ADULT DAY SERVICES

HOPE BRIDGE AT THE HOLLIES

HOPE BRIDGE AT THE OAKS

LEXINGTON DAY HEALTH CENTER

SC EPISCOPAL HOME AT STILL HOPES ADULT DAY CARE

CUTRI KRISTEN PH#: 803-796-5192

WRIGHT BARBARA T PH#: 803-791-3256

REDDING MELODY PH#:

CUTRI KRISTEN PH#: 803-796-5192

BLAND MARY JOYCE PH#: 803-939-8400

ROBERTSON NIKKI W PH#: 803-796-6490

94

92

180

165

60

12

2010 STATE ST

1111 STATE ST

2708 HEBRON RD

3532 LEAPHART RD

700 KNOX ABBOTT DR

1 STILL HOPES DR

Lexington / Corporation

Lexington / Corporation

Lexington / Corporation

Lexington / Corporation

Lexington / Non-Profit Corporation

Lexington / Corporation

ADC-0015 / 09/30/2019

ADC-0270 / 12/31/2018

ADC-0297 / 10/31/2019

ADC-0408 / 08/31/2019

ADC-0139 / 02/28/2019

ADC-0063 / 07/31/2019

CAYCE, SC 29033-3957 FAC.#:803-223-9800

CAYCE, SC 29033-4342 FAC.#:803-223-9790

W COLUMBIA, SC 29169 FAC.#:803-791-3255

WEST COLUMBIA, SC 29169 FAC.#:803-791-3256

CAYCE, SC 29033-3340 FAC.#:803-939-8400

WEST COLUMBIA, SC 29169-7164 FAC.#:803-796-6490

2010 STATE ST

1111 STATE ST

2708 HEBRON RD

2010 STATE ST

700 KNOX ABBOTT DR

PO BOX 2959

CAYCE, SC 29033-3957

CAYCE, SC 29033-4342

W COLUMBIA, SC 29169

CAYCE, SC 29033-3957

CAYCE, SC 29033-3340

WEST COLUMBIA, SC 29171-2959

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Participants:

Number of Participants:

Number of Participants:

Number of Participants:

Number of Participants:

Number of Participants:

94

92

180

165

60

12

Number of Activities/Facilities licensed: 6 Number Licensed Units: 603

HELPING HANDS ADULT DAY CARE INC

HELPING HANDS ADULT DAY CARE INC

HELPING HANDS ADULT DAY CARE INC

HELPING HANDS ADULT DAY CARE MEMORY SUPPORTS

PALMETTO HEALTH

SOUTH CAROLINA EPISCOPAL HOME AT STILL HOPES INC

Totals For Facility/License Type: Adult Day Care

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 2: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

2 hlfactcc.rdf

LexingtonCounty:

Ambulatory SurgeryFacility Type:

CHAPIN ORTHOPEDIC SURGERY CENTER

LAKE MURRAY ENDOSCOPY CENTER

MIDLANDS ENDOSCOPY CENTER

MOORE ORTHOPAEDIC CLINIC OUTPATIENT SURGERY CENTER

OUTPATIENT SURGERY CENTER OF LEXMEDCTR-LEXINGTON

SOUTH CAROLINA ENDOSCOPY CENTER

PH#:

SEASE RN CINDY G PH#: 803-407-6767

MINHAS BALBIR S PH#: 803-749-3770

MERRITT RN STACI H PH#: 803-227-8083

SIPE ROGER L PH#: 803-358-6100

EDMONDSON DOREEN O PH#: 803-794-4585

3

2

2

5

5

4

COLUMBIA AVE

100 PALMETTO HEALTH PKWY STE 100

1 WELLNESS BLVD STE 111

104 SALUDA POINTE DR

811 W MAIN ST

131 SUMMERPLACE DR

Lexington / Limited Liability

Lexington / Ltd. Liability

Lexington / Ltd. Liability

Lexington / Ltd. Liability

Lexington / Non-Profit Corporation

Lexington / Ltd. Liability

ASF-0129 / 06/30/2019

ASF-0076 / 10/31/2019

ASF-0093 / 02/28/2019

ASF-0109 / 12/31/2019

ASF-0057 / 08/31/2019

ASF-0036 / 12/31/2018

CHAPIN, SC 29036 FAC.#:803-941-8096

COLUMBIA, SC 29212-1748 FAC.#:803-407-6767

IRMO, SC 29063-2873 FAC.#:803-749-3770

LEXINGTON, SC 29072 FAC.#:803-939-5050

LEXINGTON, SC 29072-2500 FAC.#:803-358-6100

WEST COLUMBIA, SC 29169-3058 FAC.#:803-794-4585

COLUMBIA AVE

1A BURTON HILLS BLVD

PO BOX 94

104 SALUDA POINTE DR

2720 SUNSET BLVD

131 SUMMERPLACE DR

CHAPIN, SC 29036

NASHVILLE, TN 37215-6187

COLUMBIA, SC 29202-0094

LEXINGTON, SC 29072

WEST COLUMBIA, SC 29169-4810

WEST COLUMBIA, SC 29169-3058

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Operating Rooms:

Operating Rooms:

Operating Rooms:

Operating Rooms:

Operating Rooms:

Operating Rooms:

2

0

0

4

4

0

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

1

0

0

1

0

0

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

0

2

2

0

1

4

CHAPIN ORTHOPEDIC SURGERY CENTER LLC

COLUMBIA ASC NORTHWEST LLC

MIDLANDS ENDOSCOPY CENTER LLC

MOORE ORTHOPAEDIC CLINIC OUTPATIENT SURGERY CENTER LLC

LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC

SOUTH CAROLINA ENDOSCOPY CENTER LLC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 3: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

3 hlfactcc.rdf

LexingtonCounty:

Ambulatory SurgeryFacility Type:

UROLOGY SURGERY CENTER

ROBERTS-BECERRA JESSICA PH#: 803-796-9968

4

139 SUMMERPLACE DR

Lexington / Ltd. Liability

ASF-0043 / 09/30/2019

WEST COLUMBIA, SC 29169-3058 FAC.#:803-796-9968

139 SUMMERPLACE DR

WEST COLUMBIA, SC 29169-3058

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Operating Rooms: 2 Procedure Rooms: 2 Endoscopy Rooms: 0

Number of Activities/Facilities licensed: 7 Number Licensed Units: 25

UROLOGY SURGERY CENTER LLC

Totals For Facility/License Type: Ambulatory Surgery

Facility Email: [email protected]

Licensed

Units

Page 4: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

4 hlfactcc.rdf

LexingtonCounty:

Community Residential Care FacilityFacility Type:

BROOK PINE COMMUNITY RESIDENTIAL CARE FACILITY

BROOKWOOD COMMUNITY RESIDENCE

CAROLINA GARDENS AT HARBISON

CAROLINA GARDENS AT LEXINGTON

CAROLINA GARDENS AT WEST COLUMBIA

MURPHY LAVERNE PH#: 803-955-3821

RUFF JR MURRY J PH#: 803-532-4440

CALDWELL MATTHEW PH#: 803-749-7889

PH#:

UNTHANK RUSSELL A PH#: 803-939-3000

16

8

82

90

184

3961 FISH HATCHERY RD

181 BROOKWOOD DR

990 COLUMBIA AVE

5422 AUGUSTA RD

2705 LEAPHART RD

Lexington /

Lexington / Non-Profit Corporation

Lexington / Limited Liability

Lexington /

Lexington / Limited Liability

CRC-1302 / 06/30/2019

CRC-0879 / 09/30/2019

CRC-1932 / 12/31/2018

CRC-1907 / 08/31/2019

CRC-1910 / 08/31/2019

GASTON, SC 29053-9038 FAC.#:803-955-3821

BATESBURG, SC 29006-2324 FAC.#:803-532-4440

IRMO, SC 29063-2854 FAC.#:803-749-7889

LEXINGTON, SC 29072-3892 FAC.#:803-520-5850

WEST COLUMBIA, SC 29169-3335 FAC.#:803-939-3000

2725 BANNY JONES AVE

990 COLUMBIA AVE

5422 AUGUSTA RD

2705 LEAPHART RD

WEST COLUMBIA, SC 29170

IRMO, SC 29063-2854

LEXINGTON, SC 29072-3892

COLUMBIA, SC 29169-3335

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

LEXINGTON COUNTY COMMUNITY MENTAL HEALTH CENTER (LCCMHC)

BABCOCK CENTER INC

FC MIDLANDS HARBISON LLC

FC MIDLANDS LEXINGTON LLC

FC MIDLANDS WEST COLUMBIA LLC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

AGASS@BABCOCKCENTER,ORG

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

None

None

No

No

Yes

Yes

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

Yes

Yes

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

26

23

15

0

0

32

25

64

Page 5: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

5 hlfactcc.rdf

LexingtonCounty:

Community Residential Care FacilityFacility Type:

COLONIAL GARDENS ALZHEIMER'S SPECIAL CARE CENTER

GENERATIONS OF BATESBURG

GENERATIONS OF CHAPIN

GENERATIONS OF IRMO

JENNI-LYNN ASSISTED LIVING COMMUNITY

SURRETT DALE K PH#: 803-796-2556

NIX HAMMIE R PH#: 803-532-8428

HOLLINGSWORTH VIRGINIA PH#: 803-345-1911

EDWARDS CHARLES DAVID PH#: 803-227-8991

CASANOVA CATHY L PH#: 803-926-8600

66

88

56

78

63

3565 SUNSET BLVD

111 GENERATIONS BLVD

431 E BOUNDARY ST

7142 WOODROW ST

915 HOOK AVE

Lexington /

Lexington / Corporation

Lexington / Corporation

Lexington / Limited Liability

Lexington / Ltd. Liability

CRC-1542 / 03/31/2019

CRC-0647 / 09/30/2019

CRC-1128 / 10/31/2019

CRC-1477 / 05/31/2019

CRC-1248 / 09/30/2019

WEST COLUMBIA, SC 29169-3043 FAC.#:803-796-2556

BATESBURG, SC 29006-2315 FAC.#:803-532-8428

CHAPIN, SC 29036-8388 FAC.#:803-345-1911

IRMO, SC 29063-2832 FAC.#:803-227-8991

WEST COLUMBIA, SC 29169-5332 FAC.#:803-926-8600

3565 SUNSET BLVD

431 E BOUNDARY ST

431 E BOUNDARY ST

7142 WOODROW ST

915 HOOK AVE

WEST COLUMBIA, SC 29169-3043

CHAPIN, SC 29036-8388

CHAPIN, SC 29036-8388

IRMO, SC 29063-2832

WEST COLUMBIA, SC 29169-5332

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

COLUMBIA CARE GROUP LLC

GENERATIONS OF BATESBURG INC

GENERATIONS OF CHAPIN INC

GENERATIONS OF IRMO LLC

JENNI-LYNN ASSISTED LIVING LLC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

None

None

Yes

No

No

Yes

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Yes

No

No

Yes

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

66

0

0

0

0

66

0

0

15

0

Page 6: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

6 hlfactcc.rdf

LexingtonCounty:

Community Residential Care FacilityFacility Type:

LAUREL CREST

LEXINGTON PLACE

LIGHTHOUSE RESIDENTIAL CARE FACILITY

MORNINGSIDE OF LEXINGTON

NEW LIGHT COMMUNITY CARE

ROWLETTE-CARTER CASSANDRA N PH#: 803-796-0370

PH#:

PH#:

PRIDDY JEREMY R PH#: 803-957-3600

ANDERSON VALENCIA W PH#: 803-490-1428

26

90

10

49

14

100 JOSEPH WALKER DR

190 MSWAIN DR

4033 DELREE ST LOT # 31

218 OLD CHAPIN RD

120 ADDY LN

Lexington / Non-Profit Corporation

Lexington / Limited Liability

Lexington / Sole Proprietorship

Lexington / Ltd. Liability

Lexington / Non-Profit Corporation

CRC-1999 / 01/31/2019

CRC-1989 / 10/31/2018 (Renewal Pending)

CRC-2013 / 03/31/2019

CRC-1280 / 06/30/2019

CRC-1958 / 03/31/2019

WEST COLUMBIA, SC 29169-6939 FAC.#:803-796-0370

WEST COLUMBIA, SC 29169-4825 FAC.#:312-725-7000

WEST COLUMBIA, SC 29170 FAC.#:803-957-0583

LEXINGTON, SC 29072-2030 FAC.#:803-957-3600

LEXINGTON, SC 29072-3405 FAC.#:803-490-1428

2817 ASHLAND RD

330 N WABASH AVE STE 3700

4033 DELREE ST LOT # 31

400 CENTRE ST

812 MEADOW ST

COLUMBIA, SC 29210

CHICAGO, IL 60611-7605

WEST COLUMBIA, SC 29170

NEWTON, MA 02458-2094

COLUMBIA, SC 29205

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

LAUREL CREST RETIREMENT COMMUNITY

WEST COLUMBIA BG OPCO LLC

ANGELINE A SMITH

MORNINGSIDE OF LEXINGTON LLC

NEW LIGHT COMMUNITY RESOURCE FOUNDATION

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

None

None

Yes

No

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Yes

No

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

6

0

0

0

0

6

0

0

0

0

Page 7: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

7 hlfactcc.rdf

LexingtonCounty:

Community Residential Care FacilityFacility Type:

OAKLEAF VILLAGE OF LEXINGTON

PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA-COLUMBIA

RAPHA RESIDENTIAL CARE INC

S & S ASSISTANCE HOUSING

SC EPISCOPAL HOME AT STILL HOPES (CRCF)

ELLIOTT ASHLEY PH#: 803-808-3477

BASILE JASON PH#: 803-796-8700

PROSSER PAULA C PH#: 803-755-6541

MCCRAY JAMUS PH#: 803-358-6573

ROBERTSON NIKKI W PH#: 803-796-6490

100

91

92

5

24

800 N LAKE DR

700 DAVEGA DR

3959 FISH HATCHERY RD

800 HENDRIX ST

1 STILL HOPES DR

Lexington / Limited Liability

Lexington / Non-Profit Corporation

Lexington / Limited Liability LimitedPartnership

Lexington / Sole Proprietorship

Lexington / Corporation

CRC-2014 / 09/30/2019

CRC-0387 / 06/30/2019

CRC-1283 / 04/30/2019

CRC-1526 / 09/30/2019

CRC-0144 / 07/31/2019

LEXINGTON, SC 29072-2903 FAC.#:803-808-3477

LEXINGTON, SC 29073-9698 FAC.#:803-796-8700

GASTON, SC 29053-9038 FAC.#:803-755-6541

LEXINGTON, SC 29072-2540 FAC.#:803-358-6573

WEST COLUMBIA, SC 29169-7164 FAC.#:803-796-6490

800 N LAKE DR

700 DAVEGA DR

3959 FISH HATCHERY RD

PO BOX 1361

PO BOX 2959

LEXINGTON, SC 29072-2903

LEXINGTON, SC 29073-9698

GASTON, SC 29053-9038

LEXINGTON, SC 29071-1361

WEST COLUMBIA, SC 29171-2959

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

LEXINGTON SENIOR HOUSING I OPCO LLC

PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA

MASTERMIND LIMITED PARTNERSHIP LLP

S & S ASSISTANCE HOUSING LLC

SOUTH CAROLINA EPISCOPAL HOME AT STILL HOPES INC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

None

None

Yes

Yes

No

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Yes

Yes

No

No

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

25

20

0

0

8

24

20

0

0

24

Page 8: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

8 hlfactcc.rdf

LexingtonCounty:

Community Residential Care FacilityFacility Type:

SOUTHERN HERITAGE

TWILITE MANOR ADULT RESIDENTIAL CARE

WELLMORE OF LEXINGTON

DOUGLAS SR JONATHAN PH#: 803-796-3113

PH#:

TREMBLE WILLIAM M PH#: 803-520-1200

10

28

174

1713 CHARLESTON HWY

2306 FORREST ST

200 WELLMORE DR

Lexington / Corporation

Lexington /

Lexington /

CRC-0993 / 03/31/2019

CRC-1210 / 05/31/2019

CRC-1557 / 06/30/2019

WEST COLUMBIA, SC 29169-5051 FAC.#:803-796-3113

CAYCE, SC 29033-2124 FAC.#:803-794-7561

LEXINGTON, SC 29072 FAC.#:803-520-1200

PO BOX 25215

2306 FORRST ST

200 WELLMORE DR

COLUMBIA, SC 29224-5215

CAYCE, SC 29033

LEXINGTON, SC 29072

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 23 Number Licensed Units: 1,444

QUALITY CARE SERVICES INC

SEASHAR LLC

WELLMORE OF LEXINGTON LLC

Totals For Facility/License Type: Community Residential Care Facility

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

No

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

Yes

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

0

5

0

0

0

60

Page 9: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

9 hlfactcc.rdf

LexingtonCounty:

Habilitation R15Facility Type:

BATESBURG GROUP HOME

BRUTON SMITH ROAD GROUP HOME

HENDRIX STREET GROUP HOME

NAZARETH ROAD COMMUNITY RESIDENCE

WIRE ROAD COMMUNITY RESIDENCE I

WIRE ROAD COMMUNITY RESIDENCE II

GASS ANISTE PH#: 803-799-1970

WARD DELORIS PH#: 803-359-1350

WARD DELORIS PH#: 864-942-8900

CAUGHMAN BERNEKIA PH#: 803-957-3484

MOSS R PIKE PH#: 803-874-2664

MOSS PIKE PH#: 803-874-2664

8

8

8

8

8

8

132 PINEWOOD DR

139 BRUTON SMITH RD

425 HENDRIX ST

1118 NAZARETH RD

935-A WIRE RD

935-B WIRE RD

Lexington / State

Lexington / State

Lexington / State

Lexington / State

Lexington / State

Lexington / State

MR15-0181 / 06/30/2019

MR15-0185 / 06/30/2019

MR15-0199 / 06/30/2019

MR15-0213 / 06/30/2019

MR15-0225 / 06/30/2019

MR15-0226 / 06/30/2019

BATESBURG, SC 29006-2329 FAC.#:803-799-1970

LEXINGTON, SC 29072 FAC.#:803-359-1350

LEXINGTON, SC 29072 FAC.#:864-942-8900

LEXINGTON, SC 29073 FAC.#:803-957-3484

GILBERT, SC 29054 FAC.#:803-874-2664

GILBERT, SC 29054 FAC.#:803-874-2664

PO BOX 4706, DDSN C/O RUFUS BRITT

PO BOX 4706, DDSN C/O RUFUS BRITT

PO BOX 4706, DDSN C/O RUFUS BRITT

PO BOX 4706, DDSN C/O RUFUS BRITT

PO BOX 4706, DDSN C/O RUFUS BRITT

PO BOX 4706, DDSN C/O RUFUS BRITT

COLUMBIA, SC 29240-4706

COLUMBIA, SC 29240-4706

COLUMBIA, SC 29240-4706

COLUMBIA, SC 29240-4706

COLUMBIA, SC 29240-4706

COLUMBIA, SC 29240-4706

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 6 Number Licensed Units: 48

SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

Totals For Facility/License Type: Habilitation R15

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 10: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

10 hlfactcc.rdf

LexingtonCounty:

Home HealthFacility Type:

AMEDISYS HOME HEALTH OF LEXINGTON

LAUREL CREST HOME HEALTH

MEDICAL SERVICES OF AMERICA HOME HEALTH

CARSON ERIN PH#:

DEEL JAMES F PH#: 803-796-0370

MILLING JO PH#: 803-561-7680

13

0

35

714 S LAKE DR STE 250

100 JOSEPH WALKER DR

2 PALMETTO WOOD PKWY STE 201

Lexington / Ltd. Liability

Lexington / Corporation

Lexington / Corporation

HHA-0190 / 01/31/2019

HHA-0333 / 01/31/2019

HHA-0026 / 12/31/2018

LEXINGTON, SC 29072-3462 FAC.#:803-359-2253

WEST COLUMBIA, SC 29169-6939 FAC.#:803-796-0370

IRMO, SC 29063-2881 FAC.#:803-561-7680

714 S LAKE DR STE 250

PO BOX 609

LEXINGTON, SC 29072-3462

LEXINGTON, SC 29071

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

AMEDISYS SC LLC

LAUREL CREST RETIREMENT COMMUNITY

TRI-COUNTY HOME HEALTH CARE & SERVICES INC

Counties Served:

Counties Served:

Counties Served:

Aiken, Bamberg, Barnwell, Calhoun, Edgefield, Lee, Lexington, McCormick, Newberry,

Orangeburg, Richland, Saluda, Sumter

Lexington

Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Calhoun,

Cherokee, Chester, Clarendon, Colleton, Dorchester, Edgefield, Fairfield,

Greenville, Greenwood, Hampton, Jasper, Kershaw, Lancaster, Laurens, Lee,

Lexington, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda,

Spartanburg, Sumter, Union, York

License Restrictions:

License Restrictions:

License Restrictions:

RESTRICTED TO RESIDENTS OF LAUREL CREST CAMPUS ONLY

Physical Therapy:

Physical Therapy:

Physical Therapy:

Y

N

Y

Speech Therapy:

Speech Therapy:

Speech Therapy:

Y

N

Y

Occupational Therapy:

Occupational Therapy:

Occupational Therapy:

Y

N

Y

Med. Social Services:

Med. Social Services:

Med. Social Services:

Y

N

Y

Home Health Aid:

Home Health Aid:

Home Health Aid:

Y

Y

Y

Medical Supplies/Appliances/Durable Medical Equipment:

Medical Supplies/Appliances/Durable Medical Equipment:

Medical Supplies/Appliances/Durable Medical Equipment:

N

N

N

Other:

Other:

Other:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 11: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

11 hlfactcc.rdf

LexingtonCounty:

Home HealthFacility Type:

NHC HOMECARE-MIDLANDS

OPTUM WOMEN'S AND CHILDREN'S HEALTH LLC

STILL HOPES HOME HEALTH

TIDEWATER HOME HEALTH PA

MARCOS TOM PH#: 803-939-0266

ACKERMAN KRISTI PH#:

ROBERTSON NIKKI W PH#: 803-796-6490

SHUTTLEWORTH ERIKA PH#: 803-757-7017

6

13

1

2

3229 SUNSET BLVD STE N

107 WESTPARK BLVD STE 110

1 STILL HOPES DR

2858 SUNSET BLVD

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Corporation

Lexington / Partnership

HHA-0151 / 04/30/2019

HHA-0130 / 03/31/2019

HHA-0199 / 12/31/2018

HHA-0241 / 03/31/2019

WEST COLUMBIA, SC 29169-3202 FAC.#:803-939-0266

COLUMBIA, SC 29210 FAC.#:803-750-0022

WEST COLUMBIA, SC 29169-7164 FAC.#:803-223-6173

WEST COLUMBIA, SC 29169 FAC.#:803-757-7017

PO BOX 3876

PO BOX 2959

215 MEDICAL CIR

WEST COLUMBIA, SC 29171-3876

WEST COLUMBIA, SC 29171-2959

WEST COLUMBIA, SC 29169-3653

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

NHC HOMECARE-SOUTH CAROLINA LLC

OPTUM WOMEN'S AND CHILDREN'S HEALTH LLC

SOUTH CAROLINA EPISCOPAL HOME AT STILL HOPES INC

TIDEWATER HOME HEALTH PA

Counties Served:

Counties Served:

Counties Served:

Counties Served:

Calhoun, Fairfield, Kershaw, Lexington, Richland, Sumter

Aiken, Beaufort, Berkeley, Charleston, Colleton, Dorchester, Fairfield,

Georgetown, Kershaw, Lancaster, Lexington, Newberry, Richland

Lexington, Special Note - SERVING CAMPUS RESIDENTS ONLY

Lexington, Richland

License Restrictions:

License Restrictions:

License Restrictions:

License Restrictions:

OBSTETRIC PATIENTS ONLY

SERVING CAMPUS RESIDENTS ONLY

Physical Therapy:

Physical Therapy:

Physical Therapy:

Physical Therapy:

Y

N

N

Y

Speech Therapy:

Speech Therapy:

Speech Therapy:

Speech Therapy:

Y

N

N

Y

Occupational Therapy:

Occupational Therapy:

Occupational Therapy:

Occupational Therapy:

Y

N

N

Y

Med. Social Services:

Med. Social Services:

Med. Social Services:

Med. Social Services:

Y

N

N

Y

Home Health Aid:

Home Health Aid:

Home Health Aid:

Home Health Aid:

Y

N

Y

Y

Medical Supplies/Appliances/Durable Medical Equipment:

Medical Supplies/Appliances/Durable Medical Equipment:

Medical Supplies/Appliances/Durable Medical Equipment:

Medical Supplies/Appliances/Durable Medical Equipment:

N

N

N

Y

Other:

Other:

Other:

Other:

DIETARY CONSULTATION

IV THERAPY & SERVICE TO OBSTETRICAL PATIENTS

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 12: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

12 hlfactcc.rdf

LexingtonCounty:

Home HealthFacility Type:

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 7 Number Licensed Units: 70

Totals For Facility/License Type: Home Health

Licensed

Units

Page 13: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

13 hlfactcc.rdf

LexingtonCounty:

Hospice FacilityFacility Type:

AGAPE HOUSE OF LEXINGTON

DILLARD REBECCA J PH#: 803-776-4484

30

128 LIBRARY HILL LN

Lexington / Corporation

HPF-0029 / 03/31/2019

LEXINGTON, SC 29072-3893 FAC.#:803-520-5940

128 LIBRARY HILL LN

LEXINGTON, SC 29072-3893

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 1 Number Licensed Units: 30

AGAPE COMMUNITY HOSPICE OF THE GRAND STRAND INC

Totals For Facility/License Type: Hospice Facility

Facility Email: [email protected]

Licensed

Units

Page 14: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

14 hlfactcc.rdf

LexingtonCounty:

Hospice ProgramFacility Type:

ABBEY ROAD HOSPICE

AGAPE HOSPICE OF THE UPSTATE

ALL SEASONS HOSPICE

TAYLOR BRAD PH#: 803-551-5552

STONE KELLY PH#: 803-454-6113

REIGLE DEBRA M PH#: 864-227-8855

5

46

14

5429 BUSH RIVER RD

1053 CENTER ST

7142 WOODROW ST

Lexington / Limited Liability

Lexington / Corporation

Lexington / Corporation

HPC-0127 / 08/31/2019

HPC-0129 / 10/31/2018 (Renewal Pending)

HPC-0179 / 02/28/2019

COLUMBIA, SC 29212-3008 FAC.#:803-551-5552

WEST COLUMBIA, SC 29169-6749 FAC.#:803-454-6113

IRMO, SC 29063-2832 FAC.#:803-602-0300

5429 BUSH RIVER RD

1053 CENTER ST

7142 WOODROW ST

COLUMBIA, SC 29212-3008

WEST COLUMBIA, SC 29169-6749

IRMO, SC 29063-2832

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 3 Number Licensed Units: 65

ABBEY ROAD HOSPICE LLC

AGAPE COMMUNITY HOSPICE OF THE GRAND STRAND INC

ALL SEASONS HEALTHCARE INC

Counties Served:

Counties Served:

Counties Served:

Fairfield, Kershaw, Lexington, Newberry, Richland

Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley,

Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton,

Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Georgetown,

Greenville, Greenwood, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee,

Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens,

Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg, York

Aiken, Bamberg, Barnwell, Calhoun, Edgefield, Fairfield, Kershaw, Lexington,

Newberry, Orangeburg, Richland, Saluda, Sumter, Union

Totals For Facility/License Type: Hospice Program

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 15: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

15 hlfactcc.rdf

LexingtonCounty:

Hospital or Institutional General InfirmaryFacility Type:

LEXINGTON MEDICAL CENTER

SOUTH CAROLINA VOCATIONAL REHABILITATION EVALUATION

CENTER

THREE RIVERS BEHAVIORAL HEALTH

AUGSBURGER TOD PH#: 803-791-2000

CATO ALISON PH#: 803-896-6040

MARCUS SHANNON PH#: 803-796-9911

438

30

122

2720 SUNSET BLVD

1400 BOSTON AVE

2900 SUNSET BLVD

Lexington / Non-Profit Corporation

Lexington / State

Lexington / Limited Liability

HTL-0500 / 03/31/2019

HTL-0426 / 09/30/2019

HTL-0808 / 10/31/2019

WEST COLUMBIA, SC 29169-4810 FAC.#:803-791-2000

WEST COLUMBIA, SC 29170-2138 FAC.#:803-896-6040

WEST COLUMBIA, SC 29169-3422 FAC.#:803-796-9911

2720 SUNSET BLVD

1400 BOSTON AVE

2900 SUNSET BLVD

WEST COLUMBIA, SC 29169-4810

WEST COLUMBIA, SC 29170-2138

WEST COLUMBIA, SC 29169-3422

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds:

Licensed Beds:

Licensed Beds:

General:

General:

General:

438

30

0

Psychiatric:

Psychiatric:

Psychiatric:

0

0

105

Rehab:

Rehab:

Rehab:

0

0

0

Substance Abuse:

Substance Abuse:

Substance Abuse:

0

0

17

Other Beds :

Other Beds :

Other Beds :

NICU:

NICU:

NICU:

0

0

0

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

20

0

0

Number of Activities/Facilities licensed: 3 Number Licensed Units: 590

LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC

SOUTH CAROLINA VOCATIONAL REHABILITATION DEPARTMENT

THREE RIVERS BEHAVIORAL HEALTH LLC

Totals For Facility/License Type: Hospital or Institutional General Infirmary

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Abortions, Trauma Center Level III, Perinatal Level II

None

JCAHO Accredited

Page 16: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

16 hlfactcc.rdf

LexingtonCounty:

Inhome Care ProviderFacility Type:

ALLCAREGIVERS INC

ASSISTING HANDS HOME CARE

ATTENTIVE ANGELS HOME CARE

BELLA HOME CARE OF THE MIDLANDS

BRIGHTSTAR HEALTHCARE OF LEXINGTON/WEST COLUMBIA

BROOK HEALTH CARE LLC

CARE BY GENERATIONS

CARING HEALTHCARE INC

PH#:

PH#:

BROWN DAVETTE PH#: 803-888-7857

PH#:

WHITTELSEY SUSAN PH#: 843-837-3773

PH#:

EDWARDS CHARLES D PH#: 803-345-8745

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

4727-C SUNSET BLVD

203 OLD CHAPIN RD UNIT 211

1710 SUNSET BLVD STE B

113 ST ANDREWS CT

114 HAYGOOD ST STE A

200 CLARK ST STE 107

429 E BOUNDARY ST

6 B BUSH RIVER CT

Lexington / Corporation

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Corporation

IHCP-0216 / 07/31/2019

IHCP-0494 / 05/31/2019

IHCP-0553 / 05/31/2019

IHCP-0848 / 04/30/2019

IHCP-0830 / 09/30/2019

IHCP-0112 / 04/30/2019

IHCP-0513 / 02/28/2019

IHCP-0145 / 05/31/2019

LEXINGTON, SC 29072-9151 FAC.#:803-951-0771

LEXINGTON, SC 29072-2083 FAC.#:803-661-7557

WEST COLUMBIA, SC 29169 FAC.#:803-888-7857

COLUMBIA, SC 29210 FAC.#:803-404-3978

LEXINGTON, SC 29072 FAC.#:803-358-8315

CHAPIN, SC 29036-8633 FAC.#:803-941-7231

CHAPIN, SC 29036-8388 FAC.#:803-345-8745

COLUMBIA, SC 29210-4858 FAC.#:803-772-2231

4727-C SUNSET BLVD

PO BOX 2563

1710 SUNSET BLVD STE B

PO BOX 484

429 E BOUNDARY ST

6 B BUSH RIVER CT

LEXINGTON, SC 29072-9151

LEXINGTON, SC 29071-2563

WEST COLUMBIA, SC 29169

CHAPIN, SC 29036

CHAPIN, SC 29036-8388

COLUMBIA, SC 29210-4858

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

ALLCAREGIVERS INC

TEAM JAYNE LLC

ATTENTIVE ANGELS HOME CARE

PREMIERE BUSINESS PURSUITS

S S & J ASSOCIATES LLC

BROOK HEALTH CARE LLC

GEN-ED LLC

CARING HEALTHCARE INC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 17: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

17 hlfactcc.rdf

LexingtonCounty:

Inhome Care ProviderFacility Type:

COMFORT KEEPERS OF WEST COLUMBIA

COMPANION HOMECARE AND MEDICAL STAFFING

DAYBREAK ADULT CARE SERVICES

DLORAH HOME CARE SERVICES

EPIC EXTRAORDINARY PERSONALIZED IN HOME CARE (NON-

MEDICAL)

FIRSTLIGHT HOMECARE OF COLUMBIA

GRACE CAREGIVERS

PH#:

PH#:

PH#:

PH#:

PH#:

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

3214 LEAPHART RD STE C

3604 FERNANDINA RD

123 LIBRARY HILL LN STE A

3600 FERNANDINA RD

21 LOVE VALLEY CT

1309 AUGUSTA RD

814 E MAIN ST

Lexington / Corporation

Lexington / Limited Liability

Lexington / Corporation

Lexington /

Lexington / Corporation

Lexington /

Lexington / Limited Liability

IHCP-0221 / 07/31/2019

IHCP-0802 / 11/30/2018

IHCP-0003 / 12/31/2019

IHCP-0152 / 05/31/2019

IHCP-0563 / 06/30/2019

IHCP-0065 / 02/28/2019

IHCP-0722 / 05/31/2019

WEST COLUMBIA, SC 29169-3005 FAC.#:803-739-4442

COLUMBIA, SC 29210 FAC.#:706-445-9419

LEXINGTON, SC 29072-3895 FAC.#:803-356-4451

COLUMBIA, SC 29210-5221 FAC.#:803-798-1300

CHAPIN, SC 29036 FAC.#:803-730-5797

WEST COLUMBIA, SC 29169 FAC.#:803-356-0916

LEXINGTON, SC 29072-3612 FAC.#:803-399-8014

3214 LEAPHART RD STE C

123 LIBRARY HILL LN STE A

PO BOX 210594

21 LOVE VALLEY CT

1309 AUGUSTA RD

105 WOOD DALE DR

WEST COLUMBIA, SC 29169-3005

LEXINGTON, SC 29072-3895

COLUMBIA, SC 29221-0594

CHAPIN, SC 29036

WEST COLUMBIA, SC 29169

LEXINGTON, SC 29072

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

BLAKEMORE & DUNN INC

COMPANION HOMECARE AND MEDICAL STAFFING LLC

DAYBREAK ADULT CARE SERVICES INC

DLORAH LLC

CINDY KELLETT

PRICELESS HOMECARE LLC

GRACE CAREGIVERS LLC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

MICHELLE@COMPANIONHOMECAREANDSTAFFING.

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 18: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

18 hlfactcc.rdf

LexingtonCounty:

Inhome Care ProviderFacility Type:

HANDS AND HEARTS HOME CARE

HOMECARE SOLUTIONS SC

IN HOME CARE SERVICES

KEY CHOICE HOME CARE

KH NURSING SERVICES

KOGER HOME CARE

MCLEOD HOME CARE

MIDLANDS BE WELL HOME SERVICES

PH#:

TUTTLE MELISSA PH#: 803-764-7559

PH#:

PH#:

PH#:

PH#:

PH#:

COOPER CATHI PH#: 803-251-4670

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

1213 STATE ST

100 ASHLAND PARK LN STE C

132 BENTGRASS LN

322A S LAKE DR, STE 3

142 GREENBANK DR

1625 CHARLESTON HWY STE C 2ND LEVEL

304 KENWOOD DR

102 FORTRESS DR

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Non-Profit Corporation

IHCP-0095 / 04/30/2019

IHCP-0775 / 09/30/2019

IHCP-0683 / 03/31/2019

IHCP-0292 / 09/30/2019

IHCP-0851 / 05/31/2019

IHCP-0613 / 09/30/2019

IHCP-0741 / 07/31/2019

IHCP-0050 / 01/31/2019

CAYCE, SC 29033 FAC.#:803-926-1669

COLUMBIA, SC 29210 FAC.#:803-764-7559

GASTON, SC 29053 FAC.#:803-682-3977

LEXINGTON, SC 29072 FAC.#:803-485-1284

LEXINGTON, SC 29073 FAC.#:803-820-0698

WEST COLUMBIA, SC 29169 FAC.#:803-794-9740

LEXINGTON, SC 29072 FAC.#:803-233-3343

CHAPIN, SC 29036 FAC.#:803-251-4670

1213 STATE ST

100 ASHLAND PARK LN STE C

132 BENTGRASS LN

PO BOX 84246

1925 CHARLESTON HWY STE C 2ND LEVEL

PO BOX 805

CAYCE, SC 29033

COLUMBIA, SC 29210

GASTON, SC 29053

LEXINGTON, SC 29072

WEST COLUMBIA, SC 29169

WHITE ROCK, SC 29177

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

HANDS AND HEARTS HOME CARE

HOMECARE SOLUTIONS SC LLC

IN HOME CARE SERVICES DEVELOPMENT LLC

KEY CARE HEALTH SERVICES LLC

KIMBERLY HARE LLC

KOGER HOME CARE LLC

MCLEOD HOME CARE LLC

LUTHERAN HOMES OF SOUTH CAROLINA INC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 19: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

19 hlfactcc.rdf

LexingtonCounty:

Inhome Care ProviderFacility Type:

PERSONAL CARE PLUS LLC

RIGHT AT HOME - COLUMBIA

SHEPPARD'S HELPING HANDS

SOLUTIONS FOR LIVING AT HOME

SUPERIOR CARE TEAM

ULTRA HOME CARE SERVICES

PH#:

PH#:

PH#:

CISNEROS JOAN PH#: 803-223-6173

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

989 KNOX ABBOTT DR STE 110

1904 SUNSET BLVD STE D

311 W COLUMBIA AVE

945 9TH ST

1508 EMORY CT

4031 CHARLESTON HWY

Lexington / Limited Liability

Lexington / Corporation

Lexington / Limited Liability Company(single member)

Lexington / Corporation

Lexington / Limited Liability

Lexington / Limited Liability

IHCP-0307 / 09/30/2019

IHCP-0029 / 10/31/2019

IHCP-0175 / 06/30/2019

IHCP-0341 / 11/30/2018

IHCP-0794 / 11/30/2019

IHCP-0636 / 10/31/2018 (Renewal Pending)

CAYCE, SC 29033 FAC.#:803-794-4060

WEST COLUMBIA, SC 29169 FAC.#:803-551-4004

BATESBURG, SC 29006 FAC.#:803-687-1613

CAYCE, SC 29033-3343 FAC.#:803-223-6173

COLUMBIA, SC 29212 FAC.#:803-661-0240

WEST COLUMBIA, SC 29172-2907 FAC.#:803-269-8170

PO BOX 4506

1904 SUNSET BLVD STE D

311 W COLUMBIA AVE

PO BOX 2959

1508 EMORY CT

165 CRANBROOK CT

WEST COLUMBIA, SC 29171-4506

WEST COLUMBIA, SC 29169

BATESBURG, SC 29006

WEST COLUMBIA, SC 29171-2959

COLUMBIA, SC 29212

GASTON, SC 29053

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 29 Number Licensed Units: - 29

PERSONAL CARE PLUS LLC

BROWN AND ASSOCIATES HOME HEALTH SERVICES INC

SHEPPARD S HELPING HANDS LLC

SC EPISCOPAL HOME AT STILL HOPES

SUPERIOR CARE TEAM LLC

ULTRA HOME CARE SERVICES LLC

Totals For Facility/License Type: Inhome Care Provider

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 20: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

20 hlfactcc.rdf

LexingtonCounty:

Nursing HomeFacility Type:

BRIAN CENTER OF NURSING CARE-ST ANDREWS

LAUREL CREST RETIREMENT COMMUNITY

LEXINGTON MEDICAL CENTER EXTENDED CARE

MILLENNIUM POST ACUTE REHABILITATION

MORLEY MILLICENT PH#: 803-798-9715

DEEL JAMES F PH#: 803-796-0370

GILL KATHRYN PH#: 803-359-5181

NADKARNI NATASHA PH#: 803-796-8024

108

12

388

132

3514 SIDNEY RD

100 JOSEPH WALKER DR

815 OLD CHEROKEE RD

2416 SUNSET BLVD

Lexington / Ltd. Liability

Lexington / Non-Profit Corporation

Lexington / Corporation

Lexington / Corporation

NCF-0875 / 05/31/2019

NCF-1001 / 01/31/2019

NCF-0730 / 12/31/2018

NCF-0948 / 11/30/2018

COLUMBIA, SC 29210-4494 FAC.#:803-798-9715

WEST COLUMBIA, SC 29169-6939 FAC.#:803-796-0370

LEXINGTON, SC 29072-8115 FAC.#:803-359-5181

WEST COLUMBIA, SC 29169-4791 FAC.#:803-796-8024

3514 SIDNEY RD

2817 ASHLAND RD

815 OLD CHEROKEE RD

27101 PUERTA REAL STE 450

COLUMBIA, SC 29210-4494

COLUMBIA, SC 29210

LEXINGTON, SC 29072-8115

MISSION VIEJO, CA 92691

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

Nursing Home:

Nursing Home:

Nursing Home:

Nursing Home:

108

0

388

132

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

0

12

0

0

BRIAN CENTER/ST ANDREWS LLC

LAUREL CREST RETIREMENT COMMUNITY

LEXMED INC

STONEY HILL HEATLHCARE INC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

None

No

No

Yes

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

Yes

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

Page 21: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

21 hlfactcc.rdf

LexingtonCounty:

Nursing HomeFacility Type:

NHC HEALTHCARE LEXINGTON

OPUS POST ACUTE REHABILITATION

PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA-COLUMBIA

RETREAT AT WELLMORE OF LEXINGTON

MANLEY MICHAEL W PH#: 803-939-0026

PH#:

BASILE JASON PH#: 803-796-8700

TREMBLE WILLIAM M PH#: 803-520-1200

170

100

44

60

2993 SUNSET BLVD

300 AGAPE DR

700 DAVEGA DR

200 WELLMORE DR BLDG #4

Lexington / Ltd. Liability

Lexington / Corporation

Lexington / Non-Profit Corporation

Lexington /

NCF-0798 / 06/30/2019

NCF-0976 / 12/31/2018

NCF-0545 / 12/31/2018

NCF-0966 / 07/31/2019

WEST COLUMBIA, SC 29169-3421 FAC.#:803-939-0026

WEST COLUMBIA, SC 29169-3307 FAC.#:803-739-5282

LEXINGTON, SC 29073-9698 FAC.#:803-796-8700

LEXINGTON, SC 29072 FAC.#:803-520-1200

2993 SUNSET BLVD

27101 PUERTA REAL STE 450

700 DAVEGA DR

3530 TORINGDON WY STE 204

WEST COLUMBIA, SC 29169-3421

MISSION VIEJO, CA 92691-8566

LEXINGTON, SC 29073-9698

CHARLOTTE, NC 28277

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

Nursing Home:

Nursing Home:

Nursing Home:

Nursing Home:

170

100

44

60

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

0

0

0

0

NHC HEALTHCARE/LEXINGTON LLC

SOUTHERN CHARM HEALTHCARE INC

PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA

WELLMORE OF LEXINGTON LLC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

Alzheimer Care:

None

None

None

None

No

No

Yes

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

Yes

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

Page 22: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

22 hlfactcc.rdf

LexingtonCounty:

Nursing HomeFacility Type:

SOUTH CAROLINA EPISCOPAL HOME AT STILL HOPE

ROBERTSON NIKKI W PH#: 803-796-6490

62

1 STILL HOPES DR

Lexington / Corporation

NCF-0392 / 12/31/2018

WEST COLUMBIA, SC 29169-7164 FAC.#:803-796-6490

PO BOX 2959

WEST COLUMBIA, SC 29171-2959

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds: Nursing Home: 62 Institutional Nursing Home: 0

Number of Activities/Facilities licensed: 9 Number Licensed Units: 1,076

SOUTH CAROLINA EPISCOPAL HOME AT STILL HOPES INC

Totals For Facility/License Type: Nursing Home

Facility Email: [email protected]

Licensed

Units

Certifications:

Alzheimer Care:

None

NoAlzheimer Unit:Yes Max # Resident: Max # Beds:0 0

Page 23: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

23 hlfactcc.rdf

LexingtonCounty:

PSAD OutpatientFacility Type:

COLUMBIA METRO TREATMENT CENTER

LEXINGTON TREATMENT SPECIALISTS

DUGGER DONNA PH#:

LASZCZYNSKI DO ALAN D PH#:

1

1

560 CHRIS DR

185 LOTT CT

Lexington / Limited Liability LimitedPartnership

Lexington / Limited Liability

OTPN-0026 / 09/30/2019

OTPN-0198 / 11/30/2019

WEST COLUMBIA, SC 29169 FAC.#:803-791-9422

WEST COLUMBIA, SC 29169

8529 SOUTHPARK CIR STE 270

PO BOX 666

ORLANDO, FL 32819-9017

PIEDMONT, SC 29673

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 2 Number Licensed Units: 2

METRO TREATMENT OF SOUTH CAROLINA

LEXINGTON TREATMENT SPECIALISTS LLC

Totals For Facility/License Type: PSAD Outpatient

Facility Email:

Facility Email:

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Narcotics Treatment Program, Methodone Treatment Program

Narcotics Treatment Program, Methodone Treatment Program

Page 24: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

24 hlfactcc.rdf

LexingtonCounty:

Renal DialysisFacility Type:

FRESENIUS KIDNEY CARE SOUTH CONGAREE

FRESENIUS MEDICAL CARE BATESBURG-LEESVILLE

FRESENIUS MEDICAL CARE LEXINGTON

FRESENIUS MEDICAL CARE WEST COLUMBIA

GASTON DIALYSIS

MONCURE ANNE M PH#: 803-865-4500

GORDON JERMAINE PH#: 803-604-8002

THOMAS JANICE G PH#: 803-695-0145

THOMPSON ROBBIE PH#: 803-733-1764

BROWN ANTOINETTE PH#:

21

21

21

20

11

1000 RAMBLIN RD

303 VILLAGE SQUARE DR

131 WHISPERING WINDS DR

105 SUM MOR DR

5224 HWY 321

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Limited Liability

Lexington / Corporation

ERD-0245 / 04/30/2019

ERD-0161 / 02/28/2019

ERD-0107 / 02/28/2019

ERD-0049 / 02/28/2019

ERD-0205 / 05/31/2019

WEST COLUMBIA, SC 29172 FAC.#:803-722-6048

LEESVILLE, SC 29070-7055 FAC.#:803-604-8002

LEXINGTON, SC 29072-3869 FAC.#:803-695-0145

WEST COLUMBIA, SC 29169-4828 FAC.#:803-733-1764

GASTON, SC 29053-9194 FAC.#:803-796-7830

1000 RAMBLIN RD

303 VILLAGE SQUARE DR

131 WHISPERING WINDS DR

105 SUM MOR DR

5200 VIRGINIA WAY

WEST COLUMBIA, SC 29172

LEESVILLE, SC 29070-7055

LEXINGTON, SC 29072-3869

WEST COLUMBIA, SC 29169-4828

BRENTWOOD, TN 37027-7569

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 5 Number Licensed Units: 94

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

21

21

21

20

11

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

0

0

0

0

0

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS LLC

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS LLC

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS LLC

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS LLC

TOTAL RENAL CARE INC

Totals For Facility/License Type: Renal Dialysis

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 25: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

25 hlfactcc.rdf

LexingtonCounty:

Residential Treatment for Children & AdolescentsFacility Type:

THREE RIVERS RESIDENTIAL TREATMENT-MIDLANDS CAMPUS

ABBOTT JACQUELINE PH#: 803-791-9918

64

200 ERMINE RD

Lexington / Corporation

RTF-0018 / 01/31/2019

WEST COLUMBIA, SC 29170-2024 FAC.#:803-791-9918

200 ERMINE RD

WEST COLUMBIA, SC 29170-2024

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 1 Number Licensed Units: 64

THREE RIVERS RESIDENTIAL TREATMENT-MIDLANDS CAMPUS INC

Totals For Facility/License Type: Residential Treatment for Children & Adolescents

Facility Email: [email protected]

Licensed

Units

Page 26: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

26 hlfactcc.rdf

LexingtonCounty:

Tattoo FacilityFacility Type:

ANIMATED CANVAS OF LEXINGTON

GYPSY MOON TATTOO

HOWLING DOG COLLECTIVE

LUCKY 7'S ELECTRIC TATTOO COMPANY

MR SHORTY'S TATTOO EMPORIUM

TATWAY TATTOOS

TATWAY TATTOOS TOO LLC

TOYE SHOP INK

KUMO SCOT PH#: 951-318-6894

WILEY JOSH PH#: 803-546-2149

PH#:

MCMAHON SHAWN PH#: 803-446-8163

MARIKA LAURNA V PH#: 803-808-5761

MUNN JR LARRY W PH#: 803-665-8621

PH#:

COLLINS DUSTIN PH#:

4

4

4

4

4

4

4

3

4325 AUGUSTA RD STE E

6145 SAINT ANDREWS RD

4018 FERNANDINA RD

3937 PLATT SPRINGS RD STE B

4346 AUGUSTA RD

1500 W MAIN ST STE B

5305 I HWY 321

5366B PLATT SPRINGS RD

Lexington / Sole Proprietorship

Lexington / Corporation

Lexington /

Lexington / Limited Liability

Lexington / Ltd. Liability

Lexington /

Lexington / Sole Proprietorship

Lexington / Limited Liability Company(multiple member)

TF-0094 / 06/30/2019

TF-0264 / 12/31/2019

TF-0307 / 07/31/2019

TF-0148 / 12/31/2018

TF-0021 / 09/30/2019

TF-0178 / 01/31/2019

TF-0296 / 07/31/2018 (Renewal Pending)

TF-0175 / 10/31/2019

LEXINGTON, SC 29073-7941 FAC.#:803-359-3241

COLUMBIA, SC 29212-3121 FAC.#:803-851-3307

COLUMBIA, SC 29212 FAC.#:000-000-0000

WEST COLUMBIA, SC 29170-1605 FAC.#:803-755-7472

LEXINGTON, SC 29073-9151 FAC.#:803-808-5761

LEXINGTON, SC 29072-2330 FAC.#:803-399-8875

GASTON, SC 29053 FAC.#:803-665-8621

LEXINGTON, SC 29073-6741 FAC.#:803-399-1681

1209 PARK ST

6145 SAINT ANDREWS RD

4018 FERNANDINA RD

3937-B PLATT SPRINGS RD

4346 AUGUSTA RD

1500 W MAIN ST STE B

240 HERTIAGE TRAIL

1925 S LAKE DR STE 5

COLUMBIA, SC 29201-3139

COLUMBIA, SC 29212-3121

COLUMBIA, SC 29212

WEST COLUMBIA, SC 29170-1605

LEXINGTON, SC 29073-9151

LEXINGTON, SC 29072-2330

LEXINGTON, SC 29072

LEXINGTON, SC 29073-6741

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

ANIMATED CANVAS LLC

GYPSY MOON INC

WOLFCASTLE & JONES LLC

LUCKY 7'S ELECTRIC TATTOO COMPANY LLC

MR SHORTY'S TATTOO EMPORIUM LLC

TATWAY TATTOOS LLC

MUNN WAYNE & STEFEY

TOYE SHOP INK LLC

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 27: County: Lexington Facility Type: Adult Day Care · South Carolina Department of Health & Environmental Control Division of Health Licensing March 6, 2018 1 hlfactcc.rdf County:Lexington

South Carolina Department of Health & Environmental Control

Division of Health Licensing

November 9, 2018

27 hlfactcc.rdf

LexingtonCounty:

Tattoo FacilityFacility Type:

Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 8 Number Licensed Units: 31

Number of Activities/Facilities licensed in county of :

Number Licensed Units : 4,113

Totals For Facility/License Type: Tattoo Facility

Total Number of Activities/Facilities licensed: 110 Total Number Licensed Units: 4,113

Report Totals

Lexington 110# Lics:

Licensed

Units