january 9, 2019 south carolina department of health ... · blythewood, sc 29016-7221 columbia, sc...

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South Carolina Department of Health & Environmental Control Division of Health Licensing January 9, 2019 1 hlfactcc.rdf Richland County: Abortion Clinic Facility Type: PLANNED PARENTHOOD OF SOUTH ATLANTIC LOWE-HALL LISA PH#: 803-253-4908 1 2712 MIDDLEBURG DR STE 107 Richland / Non-Profit Corporation AB-0002 / 07/31/2019 COLUMBIA, SC 29204-2478 FAC.#:803-256-4908 100 S BOYLAN AVE RALEIGH, NC 27603 Facility Name Location Street Location City, State Administrator/Phone License Nbr/Expiration Date County/Ownership Type Mailing/Billing Address Licensee Number of Activities/Facilities licensed: 1 Number Licensed Units: 1 PLANNED PARENTHOOD SOUTH ATLANTIC Totals For Facility/License Type: Abortion Clinic Facility Email: [email protected] Licensed Units

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Page 1: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

1 hlfactcc.rdf

RichlandCounty:

Abortion ClinicFacility Type:

PLANNED PARENTHOOD OF SOUTH ATLANTIC

LOWE-HALL LISA PH#: 803-253-4908

1

2712 MIDDLEBURG DR STE 107

Richland / Non-Profit Corporation

AB-0002 / 07/31/2019

COLUMBIA, SC 29204-2478 FAC.#:803-256-4908

100 S BOYLAN AVE

RALEIGH, NC 27603

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: 1

PLANNED PARENTHOOD SOUTH ATLANTIC

Totals For Facility/License Type: Abortion Clinic

Facility Email: [email protected]

Licensed

Units

Page 2: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

2 hlfactcc.rdf

RichlandCounty:

Adult Day CareFacility Type:

COLUMBIA ADULT CARE

COLUMBIA ADULT CARE ON MAIN

DENT ALTERNATIVE ADULT DAY CARE HEALTH CENTER

LAUREL DAY HEALTH CENTER

MOUNTAIN TOP ADULT DAY CENTER

SHANDON DAY HEALTH CENTER

QUARLES TAMMY M PH#: 803-260-6087

QUARLES TAMMY M PH#: 803-260-6087

DENT RN BERTHA H PH#: 803-708-8955

HOPKINS CONSTANCE D PH#: 803-931-8166

KENNEDY CAROLYN PH#: 803-736-5872

WEATHERFORD VIRGINIA PH#: 803-252-1979

18

24

65

70

30

70

3127 ROSEWOOD DR

2101 MAIN ST STE H

7351 PARKLANE RD

1308 LAUREL ST

1941 DECKER BLVD

1100 SHIRLEY ST

Richland / Corporation

Richland / Corporation

Richland / Partnership

Richland / Non-Profit Corporation

Richland / Limited Liability

Richland / Non-Profit Corporation

ADC-0019 / 04/30/2019

ADC-0292 / 01/31/2020

ADC-0284 / 10/31/2019

ADC-0137 / 02/28/2019

ADC-0304 / 03/31/2019

ADC-0136 / 02/28/2019

COLUMBIA, SC 29205-3434 FAC.#:803-771-7108

COLUMBIA, SC 29201-2159 FAC.#:803-212-7005

COLUMBIA, SC 29223-7651 FAC.#:803-708-8955

COLUMBIA, SC 29201-2514 FAC.#:803-931-8166

COLUMBIA, SC 29206-3470 FAC.#:803-787-0020

COLUMBIA, SC 29205-1370 FAC.#:803-252-1979

3127 ROSEWOOD DR

2101 MAIN ST STE H

7351 PARKLANE RD

1308 LAUREL ST

1941 DECKER BLVD

1100 SHIRLEY ST

COLUMBIA, SC 29205-3434

COLUMBIA, SC 29201-2159

COLUMBIA, SC 29223-7651

COLUMBIA, SC 29201-2514

COLUMBIA, SC 29206-3470

COLUMBIA, SC 29205-1370

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:

18

24

65

70

30

70

COLUMBIA ADULT CARE INC

COLUMBIA ADULT CARE INC

BERTHA H DENT AND ERIC R DENT

PALMETTO HEALTH

MOUNTAIN TOP ADULT DAY CENTER LLC

PALMETTO HEALTH

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: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

3 hlfactcc.rdf

RichlandCounty:

Adult Day CareFacility Type:

WHITE ROCK DAY HEALTH CENTER

NEWELL MELINDA PH#: 803-732-6670

50

109 WARTBURG ST

Richland / Non-Profit Corporation

ADC-0140 / 02/28/2019

WHITE ROCK, SC 29177 FAC.#:803-732-6670

109 WARTBURG ST

WHITE ROCK, SC 29177

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Participants: 50

Number of Activities/Facilities licensed: 7 Number Licensed Units: 327

PALMETTO HEALTH

Totals For Facility/License Type: Adult Day Care

Facility Email: [email protected]

Licensed

Units

Page 4: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

4 hlfactcc.rdf

RichlandCounty:

Ambulatory SurgeryFacility Type:

BERKELEY ENDOSCOPY CENTER

CAROLINA COLONOSCOPY CENTER

CAROLINA INTERVENTIONAL PAIN INSTITUTE

COLUMBIA EYE SURGERY CENTER

COLUMBIA GASTROINTESTINAL ENDOSCOPY CENTER

MIDLANDS ORTHOPAEDICS SURGERY CENTER

BELLAMY GWENDOLYN PH#: 803-788-1120

BARTHOLOMEW DENISE PH#: 803-254-8449

HODGE JENNIFER PH#: 803-779-3263

MARTIN CARLY PH#: 803-254-7732

SEASE RN CINDY G PH#: 803-254-9588

EASLEY KELLY PH#: 803-461-4760

2

2

3

6

4

5

1072 WILDWOOD CENTRE DR

2631 FOREST DR

2611 FOREST DR

1920 PICKENS ST

2739 LAUREL ST STE 1B

1930 BLANDING ST

Richland / Ltd. Liability

Richland / Corporation

Richland / Limited Liability

Richland / Corporation

Richland / Ltd. Liability

Richland / Limited Liability

ASF-0104 / 01/31/2020

ASF-0042 / 08/31/2019

ASF-0135 / 03/31/2019

ASF-0018 / 07/31/2019

ASF-0032 / 09/30/2019

ASF-0136 / 09/30/2019

COLUMBIA, SC 29229-8420 FAC.#:803-788-1120

COLUMBIA, SC 29204-0000 FAC.#:803-254-8449

COLUMBIA, SC 29204 FAC.#:803-779-3263

COLUMBIA, SC 29201-2632 FAC.#:803-254-7732

COLUMBIA, SC 29201 FAC.#:803-254-9588

COLUMBIA, SC 29201-3520 FAC.#:803-461-4740

1072 WILDWOOD CENTRE DR

2631 FOREST DR

1655 BERNARDIN AVE STE 240

1920 PICKENS ST

1A BURTON HILLS BLVD

1930 BLANDING ST

COLUMBIA, SC 29229-8420

COLUMBIA, SC 29204-0000

COLUMBIA, SC 29204-2044

COLUMBIA, SC 29201-2632

NASHVILLE, TN 37215-6187

COLUMBIA, SC 29201-3520

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:

0

0

2

4

0

4

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

0

0

1

2

0

1

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

2

2

0

0

4

0

BERKELEY ENDOSCOPY CENTER LLC

SOUTH CAROLINA MEDICAL ENDOSCOPY LLC

CAROLINA INTERVENTIONAL PAIN INSTITUTE LLC

COLUMBIA EYE SURGERY CENTER INC

COLUMBIA ASC LLC

MIDLANDS ORTHOPAEDICS SURGERY 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 5: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

5 hlfactcc.rdf

RichlandCounty:

Ambulatory SurgeryFacility Type:

OUTPATIENT SURGERY CENTER OF LEXINGTON MEDICAL CENTER

IN IRMO

PALMETTO ENDOSCOPY SUITE

PALMETTO SURGERY CENTER

SOUTH CAROLINA ENDOSCOPY CENTER NORTHEAST LLC

SIPE ROGER L PH#: 803-749-0977

BEST RN GLENDA PH#: 803-509-5710

MCCLAMROCK FLEET L PH#: 803-865-8200

EDMONDSON DOREEN O PH#: 803-794-4585

4

2

5

5

7035 SAINT ANDREWS RD

1520 TAYLOR ST STE 250

109 BLARNEY DR

11 GATEWAY CORNERS PARK

Richland / Non-Profit Corporation

Richland / Limited Liability

Richland / Limited Liability

Richland / Ltd. Liability

ASF-0013 / 11/30/2019

ASF-0115 / 08/31/2019

ASF-0046 / 02/28/2019

ASF-0074 / 05/31/2019

COLUMBIA, SC 29212-1175 FAC.#:803-749-0924

COLUMBIA, SC 29201-2926 FAC.#:803-509-5710

COLUMBIA, SC 29223-6244 FAC.#:803-865-8200

COLUMBIA, SC 29203-8902 FAC.#:803-462-2300

2720 SUNSET BLVD

1520 TAYLOR ST STE 250

109 BLARNEY DR

11 GATEWAY CORNERS PARK

WEST COLUMBIA, SC 29169-4810

COLUMBIA, SC 29201-2926

COLUMBIA, SC 29223-6244

COLUMBIA, SC 29203-8902

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

County/Ownership TypeMailing/Billing AddressLicensee

Operating Rooms:

Operating Rooms:

Operating Rooms:

Operating Rooms:

4

0

5

0

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

Procedure Rooms:

0

0

0

0

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

Endoscopy Rooms:

0

2

0

5

Number of Activities/Facilities licensed: 10 Number Licensed Units: 38

LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC

PALMETTO ENDOSCOPY SUITE LLC

PALMETTO SURGERY CENTER LLC

CLASS PROPERTIES NORTHEAST LLC

Totals For Facility/License Type: Ambulatory Surgery

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 6: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

6 hlfactcc.rdf

RichlandCounty:

Body PiercingFacility Type:

IMMACULATE STUDIOS

KNOTTY HEADZ BODY PIERCING II

OUCH!

RAW BODY PIERCING

TRILLIONAIRE 3000

WOOTEN SARAH M PH#: 803-799-2877

RORIE WOODROW DURAN PH#: 803-212-8349

WASHINGTON LEILA PH#: 803-397-8284

WHITE RAEGIN ADAIR PH#: 803-716-7900

DAVIS WILLIE J PH#: 803-699-0114

1

1

1

1

1

2009 GREENE ST STE 116

1608 DECKER BLVD STE B

10240 TWO NOTCH RD STE 4

9557 TWO NOTCH RD STE K

7352 TWO NOTCH RD STE B

Richland / Limited Liability

Richland / Ltd. Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Sole Proprietorship

BP-0200 / 05/31/2019

BP-0201 / 06/30/2019

BP-0215 / 01/31/2019

BP-0273 / 07/31/2019

BP-0274 / 06/30/2019

COLUMBIA, SC 29205-1697 FAC.#:803-799-2877

COLUMBIA, SC 29206-5246 FAC.#:803-603-0641

COLUMBIA, SC 29229-4217 FAC.#:803-462-0101

COLUMBIA, SC 29223 FAC.#:803-764-4579

COLUMBIA, SC 29223 FAC.#:803-699-0114

2009 GREENE ST STE 116

1608 DECKER BLVD STE B

829 REDDEN ROW

PO BOX 291506

7352 TWO NOTCH RD STE B

COLUMBIA, SC 29205-1697

COLUMBIA, SC 29206-5246

BLYTHEWOOD, SC 29016-7221

COLUMBIA, SC 29229

COLUMBIA, SC 29223

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: 5

IMMACULATE STUDIOS LLC

KNOTTY HEADZ ENTERPRISES LLC

OUCH! LLC

RAW BODY PIERCING LLC

DAVIS III WILLIE J

Totals For Facility/License Type: Body Piercing

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 7: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

7 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

ADDISON'S COMMUNITY CARE HOME

AMARA PLACE AT COLUMBIA

ATRIA FOREST LAKE

B & J RESIDENTIAL CARE FACILITY

BLAKE AT WOODCREEK FARMS

DOCTOR-GREENWADE SARAH PH#: 803-736-0455

KOESTER KELLY H PH#: 803-788-9555

ELLROTT FAYE ESTES PH#: 803-790-9800

DAVIS-EARGLE EUGENIA M PH#: 803-786-0011

HERNANDEZ ROB PH#: 803-828-7370

9

59

60

5

100

4013 PERCIVAL RD

651 POLO RD

4405 FOREST DR

528 ATTERBURY DR

385 SPEARS CREEK CHURCH RD

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland /

CRC-0815 / 05/31/2019

CRC-1944 / 12/31/2018 (Renewal Pending)

CRC-1143 / 05/31/2019

CRC-1461 / 12/31/2019

CRC-1570 / 02/28/2019

COLUMBIA, SC 29229-8321 FAC.#:803-736-0455

COLUMBIA, SC 29223-2905 FAC.#:803-788-9555

COLUMBIA, SC 29206-3103 FAC.#:803-790-9800

COLUMBIA, SC 29203-3002 FAC.#:803-786-0011

ELGIN, SC 29045-9312 FAC.#:803-828-7370

PO BOX 23328

651 POLO RD

300 E MARKET ST STE 100

213 LINGSTROM LN

385 SPEARS CREEK CHURCH RD

COLUMBIA, SC 29224-3328

COLUMBIA, SC 29223

LOUISVILLE, KY 40202

COLUMBIA, SC 29212

ELGIN, SC 29045

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

County/Ownership TypeMailing/Billing AddressLicensee

ADDISON'S COMMUNITY CARE HOME INC

TWG POLO ROAD LLC

WG FOREST LAKE SH LLC

B & J RESIDENTIAL CARE FACILITY LLC

BLAKE AT WOODCREEK FARMS 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

No

Yes

Yes

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

Yes

Yes

No

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

16

0

20

0

19

16

0

40

Page 8: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

8 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

BROOKDALE COLUMBIA

BROOKDALE HARBISON

BUILDERS CARE HOME

CAROLINA GARDENS AT KATHWOOD

CARSON'S COMMUNITY CARE

SHULL BRIAN PH#: 803-741-2600

KEAR DOUGAL PH#: 803-732-0300

PH#:

PH#:

CARSON ANNIE P PH#: 803-786-7513

52

52

6

100

10

251 SPRINGTREE DR

51 WOODCROSS DR

731 SIMS AVE

4520 TRENHOLM RD

10219 FARROW RD

Richland / Limited Liability

Richland / Limited Liability

Richland / Non-Profit Corporation

Richland / Limited Liability

Richland / Sole Proprietorship

CRC-1310 / 12/31/2019

CRC-1311 / 12/31/2019

CRC-1491 / 04/30/2019

CRC-1911 / 08/31/2019

CRC-0916 / 02/28/2019

COLUMBIA, SC 29223-7989 FAC.#:803-741-2600

COLUMBIA, SC 29212-2350 FAC.#:803-732-0300

COLUMBIA, SC 29205-1837 FAC.#:803-376-8991

COLUMBIA, SC 29206-4425 FAC.#:803-787-1234

BLYTHEWOOD, SC 29016-9612 FAC.#:803-786-7513

251 SPRINGTREE DR

51 WOODCROSS DR

731 SIMS AVE

4520 TRENHOLM RD

10219 FARROW RD

COLUMBIA, SC 29223-7989

COLUMBIA, SC 29212-2350

COLUMBIA, SC 29205-1837

COLUMBIA, SC 29206-4425

BLYTHEWOOD, SC 29016-9612

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

County/Ownership TypeMailing/Billing AddressLicensee

BROOKDALE SENIOR LIVING COMMUNITIES INC

BROOKDALE SENIOR LIVING COMMUNITIES INC

ALDERSGATE SPECIAL NEEDS MINISTRY

FC MIDLANDS KATHWOOD LLC

CARSON JAMES E

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

No

Yes

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Yes

Yes

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

42

13

0

0

0

0

12

0

0

0

Page 9: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

9 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

CASUAL COMMUNITY CARE HOME

CLS CARE HOME

COUNTRY COMFORT COMMUNITY HOME

COUNTRYWOOD ASSISTED LIVING

CROSSINGS AT COLUMBIA

BRIGGS MARY E PH#: 803-788-2721

DOWDY-SPEARMAN HELEN PH#: 803-353-3151

COUNTS CLIFFORD A PH#: 803-735-9777

HUNT JOSEPH R PH#: 803-776-3873

BOWLES KAREN PH#: 803-223-9560

8

5

9

26

110

112 GOODRICH ST

1024 TUCKER TOWN RD STE 1024A

204 JOE APREE CIR

1645 RIDGE RD

2300 CLEMSON RD

Richland / Sole Proprietorship

Richland / Sole Proprietorship

Richland /

Richland / Ltd. Liability

Richland / Limited Liability

CRC-0701 / 01/31/2019

CRC-1200 / 06/30/2019

CRC-1467 / 02/28/2019

CRC-1465 / 11/30/2019

CRC-1544 / 03/31/2019

COLUMBIA, SC 29223-7725 FAC.#:803-788-2721

GADSDEN, SC 29052-9789 FAC.#:803-353-3151

BLYTHEWOOD, SC 29016-8807 FAC.#:803-735-9777

HOPKINS, SC 29061-8432 FAC.#:803-776-3873

COLUMBIA, SC 29229-8029 FAC.#:803-223-9560

PO BOX 121

1024 TUCKER TOWN RD STE 1024A

2452 ROLLING PINES RD

1645 RIDGE RD

2300 CLEMSON RD

STATE PARK, SC 29147-0121

GADSDEN, SC 29052-9789

COLUMBIA, SC 29210

HOPKINS, SC 29061-8432

COLUMBIA, SC 29229-8029

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

County/Ownership TypeMailing/Billing AddressLicensee

BRIGGS MARY

CORA SCOTT

COUNTRY COMFORT HOMES LLC

COUNTRYWOOD NURSING CENTER LLC

COLUMBIA AL OPERATIONS 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

No

No

No

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

24

0

0

0

0

24

Page 10: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

10 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

DAVIS COMMUNITY CARE HOME

DOWDY'S COMMUNITY CARE HOME #2

EUGENIA'S RESIDENTIAL CARE FACILITY

FLANAGAN COMMUNITY CARE HOME

HARBISON HALL

HARVEY ALTHEA PH#: 803-754-5677

DOWDY FRANK PH#: 803-786-2105

PH#:

BRIGGS MARY E PH#: 803-754-2136

DEQUINCEY-NEWMAN EMILY PH#: 803-731-2000

19

9

23

9

40

2306 HEYWARD BROCKINGTON RD

4609 ARLINGTON ST

2232 HEYWARD BROCKINGTON RD

665 SHARPE RD

534 WIL STEL RD

Richland / Partnership

Richland / Sole Proprietorship

Richland / Partnership

Richland / Sole Proprietorship

Richland / Partnership

CRC-0240 / 07/31/2019

CRC-0173 / 08/31/2018 (Renewal Pending)

CRC-0538 / 08/31/2019

CRC-0314 / 09/30/2019

CRC-1107 / 06/30/2019

COLUMBIA, SC 29203-9679 FAC.#:803-754-5677

COLUMBIA, SC 29203-4143 FAC.#:803-786-2105

COLUMBIA, SC 29203-9677 FAC.#:803-786-1047

COLUMBIA, SC 29203-9304 FAC.#:803-754-2136

COLUMBIA, SC 29210-3967 FAC.#:803-731-2000

PO BOX 3273

6125 LUKE ST

PO BOX 3273

665 SHARPE RD

1825 ST JULLIAN PL 5C

COLUMBIA, SC 29230-3273

COLUMBIA, SC 29203-5067

COLUMBIA, SC 29230-3273

COLUMBIA, SC 29203-9304

COLUMBIA, SC 29204

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

County/Ownership TypeMailing/Billing AddressLicensee

THOMASENA DAVIS EUGENIA M EARGLE & ELIJAH DAVIS

ANNIE R DOWDY

ELIJAH DAVIS THOMASENA DAVIS & EUGENIA M EARGLE

BRIGGS MARY E

HARBISON HALL PARTNERS

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

No

No

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

0

0

Page 11: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

11 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

HARBORCHASE OF COLUMBIA

HAVEN IN THE SUMMIT

HERITAGE AT LOWMAN RESIDENTIAL CARE

HOMESTEAD AT THE CROSSINGS

IDA LANE I CRCF

PH#:

LILLY TAMMY D PH#: 803-788-4633

HYMAN ASHLEY PH#: 803-732-8800

PH#:

BARR ANGELA W PH#: 803-786-7522

66

60

132

25

8

120 FAIRFOREST RD

3 SUMMIT TER

2101 DUTCH FORK RD

2304 CLEMSON RD

120 IDA LN

Richland / Corporation

Richland / Limited Liability Limited Partnership

Richland / Non-Profit Corporation

Richland /

Richland /

CRC-1315 / 11/30/2019

CRC-1240 / 03/31/2019

CRC-0840 / 09/30/2019

CRC-1980 / 07/31/2019

CRC-1520 / 03/31/2019

COLUMBIA, SC 29212-2308 FAC.#:803-781-2243

COLUMBIA, SC 29229-7639 FAC.#:803-788-4633

CHAPIN, SC 29036 FAC.#:803-732-8800

COLUMBIA, SC 29229 FAC.#:803-223-9560

COLUMBIA, SC 29203-9234 FAC.#:803-786-7522

120 FAIRFOREST RD

400 CENTRE ST

PO BOX 444

2304 CLEMSON RD

120 IDA LN

COLUMBIA, SC 29212-2343

NEWTON, MA 02458-2094

WHITE ROCK, SC 29177-0444

COLUMBIA, SC 29229

COLUMBIA, SC 29203-9234

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

County/Ownership TypeMailing/Billing AddressLicensee

TWENTY TWO PACK MANAGEMENT CORPORATION

MORNINGSIDE OF ANDERSON LP

LUTHERAN HOMES OF SOUTH CAROLINA INC

COLUMBIA IL INVESTORS LLC

BABACOCK CENTER 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

Yes

Yes

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Yes

Yes

Yes

Yes

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

36

60

48

11

0

29

60

48

11

0

Page 12: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

12 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

IDA LANE II CRCF

JOANNE'S COMMUNITY CARE HOME #1

JOANNE'S COMMUNITY CARE HOME II

JOY COMMUNITY CARE HOME

KENSINGTON I

BARR ANGELA W PH#: 803-786-7522

CALDWELL JOANNE M PH#: 803-736-3860

CALDWELL JOANNE M PH#: 803-736-3094

DOUGLAS JONATHAN PH#: 803-754-3157

TURNER SUSAN P PH#: 803-256-0504

8

10

9

10

8

124 IDA LN

5048 PERCIVAL RD

756 FARROWOOD DR

6800 DOBY DR

100 KENSINGTON RD

Richland /

Richland / Sole Proprietorship

Richland / Sole Proprietorship

Richland / Sole Proprietorship

Richland / Sole Proprietorship

CRC-1518 / 12/31/2019

CRC-0932 / 06/30/2019

CRC-0030 / 03/31/2019

CRC-0961 / 11/30/2019

CRC-1532 / 06/30/2019

COLUMBIA, SC 29203-9234 FAC.#:803-786-7522

ELGIN, SC 29045-9156 FAC.#:803-736-3860

COLUMBIA, SC 29223-7801 FAC.#:803-736-3094

COLUMBIA, SC 29203-5133 FAC.#:803-754-3157

COLUMBIA, SC 29203-5451 FAC.#:803-256-0504

2725 BANNY JONES AVE

PO BOX 23494

PO BOX 23494

PO BOX 25215

110 PONTIAC BUSINESS CENTER DR STE C, CHESCO SERVICES

WEST COLUMBIA, SC 29170

COLUMBIA, SC 29224-3494

COLUMBIA, SC 29224-3494

COLUMBIA, SC 29224-5215

ELGIN, SC 29045

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

County/Ownership TypeMailing/Billing AddressLicensee

BABACOCK CENTER INC

CALDWELL JOANNE M

CALDWELL JOANNE M

SCOTT DEBORAH A

CHESCO SERVICES

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

No

No

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

0

0

Page 13: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

13 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

KENSINGTON II GROUP HOME

KIVA LODGE

LEMONAIDE HOUSE

MARY'S RESIDENTIAL #2

MARY'S RESIDENTIAL CARE FACILITY

TURNER SUSAN PH#: 803-252-0848

ROUSE MATRICE PH#: 803-764-2761

ETHERIDGE LULA J PH#: 803-776-1742

SIMMONS NHAJIYAH PH#: 803-708-0300

SIMMONS NHAJIYAH RAHESSIA PH#: 803-708-1739

8

5

15

5

5

120 KENSINGTON RD

200 CLAUDE BUNDRICK RD

1018 CRYSTAL CLEAR LN

633 SHARPE RD

10425 WILSON BLVD

Richland / Sole Proprietorship

Richland / Corporation

Richland / Partnership

Richland / Sole Proprietorship

Richland / Sole Proprietorship

CRC-1536 / 11/30/2019

CRC-1092 / 07/31/2019

CRC-0924 / 05/31/2018 (Renewal Pending)

CRC-1534 / 08/31/2019

CRC-1501 / 01/31/2019

COLUMBIA, SC 29203-5451 FAC.#:803-252-0848

BLYTHEWOOD, SC 29016-9420 FAC.#:803-764-2761

HOPKINS, SC 29061-8237 FAC.#:803-776-1742

COLUMBIA, SC 29203-9304 FAC.#:803-708-0300

BLYTHEWOOD, SC 29016-9017 FAC.#:803-708-1739

1823 GADSDEN ST

1018 CRYSTAL CLEAR LN

138 CATTLE BARON LN

10425 WILSON BLVD

COLUMBIA, SC 29201-2344

HOPKINS, SC 29061-8237

ELGIN, SC 29045

BLYTHEWOOD, SC 29016-9017

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

County/Ownership TypeMailing/Billing AddressLicensee

CHESCO SERVICES

MENTAL HEALTH AMERICA OF SOUTH CAROLINA

LULA J ETHERIDGE AND NANCY A SMITH

BACOTE MARY

BACOTE MARY

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

No

No

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

0

0

Page 14: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

14 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

MIRCI GROUP HOME I

MIRCI GROUP HOME II

NORTH PINES COMMUNITY RESIDENCE

OLIVER'S CARE HOME

PALMETTOS OF PARKLANE

COLLINS TIFFANY R PH#: 803-754-8894

COLLINS TIFFANY R PH#: 803-754-8894

LOCKHART ELESHA J PH#: 803-754-6213

ANDERSON VALENCIA W PH#: 803-754-3585

DAVILA KIMBERLY P PH#: 803-741-7233

6

6

8

5

85

581 BECKMAN RD

611 BECKMAN RD

313 N PINES RD

1200 LAWHORN RD

7811 PARKLANE RD

Richland / Corporation

Richland / Corporation

Richland / Sole Proprietorship

Richland / Limited Liability

Richland / Limited Liability

CRC-1443 / 06/30/2019

CRC-1444 / 06/30/2019

CRC-1504 / 04/30/2019

CRC-1480 / 08/31/2019

CRC-1513 / 04/30/2019

COLUMBIA, SC 29203-3207 FAC.#:803-754-4221

COLUMBIA, SC 29203-3282 FAC.#:803-754-8894

BLYTHEWOOD, SC 29016-8788 FAC.#:803-754-6213

BLYTHEWOOD, SC 29016-8975 FAC.#:803-754-3585

COLUMBIA, SC 29223-5620 FAC.#:803-741-7233

1408 GREGG ST

1408 GREGG ST

313 N PINES RD

1200 LAWHORN RD

7811 PARKLANE RD

COLUMBIA, SC 29201

COLUMBIA, SC 29201

BLYTHEWOOD, SC 29016-8788

BLYTHEWOOD, SC 29016-8975

COLUMBIA, SC 29223-5620

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

County/Ownership TypeMailing/Billing AddressLicensee

MENTAL ILLNESS RECOVERY CENTER INC

MENTAL ILLNESS RECOVERY CENTER INC

CHESCO SERVICES

OLIVER CARE HOME LLC

PALMETTOS OF PARKLANE 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

No

No

No

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

24

0

0

0

0

18

Page 15: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

15 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

PASSIONATE CARE COMMUNITY CENTER

PIEDMONT PATHWAYS COMMUNITY RESIDENTIAL CARE FACILITY

PONDVIEW RESIDENTIAL CARE HOME #1

PONDVIEW RESIDENTIAL CARE HOME #2

REESE'S COMMUNITY CARE HOME #1

MARTIN DONALD E PH#: 803-404-2278

SCOTT GWENDOLYN PH#: 803-783-2273

THOMAS KATHERINE PH#: 803-735-0420

THOMAS KATHERINE W PH#: 803-735-0420

REESE JR JAMES S PH#: 803-908-3551

5

15

12

5

8

2206 HERTFORD DR

5640 LOWER RICHLAND BLVD

5342 HARDSCRABBLE RD

5338 HARDSCRABBLE RD

1203 E MULLER AVE

Richland / Sole Proprietorship

Richland / State

Richland / Sole Proprietorship

Richland / Sole Proprietorship

Richland / Corporation

CRC-1500 / 12/31/2018 (Renewal Pending)

CRC-1421 / 01/31/2019

CRC-0378 / 04/30/2019

CRC-1190 / 11/30/2019

CRC-0053 / 03/31/2019

COLUMBIA, SC 29210-6130 FAC.#:803-404-2278

HOPKINS, SC 29061-9525 FAC.#:803-783-2273

BLYTHEWOOD, SC 29016-9171 FAC.#:803-735-0420

BLYTHEWOOD, SC 29016-9171 FAC.#:803-735-0420

COLUMBIA, SC 29203-5926 FAC.#:803-760-4387

2206 HERTFORD DR

5640 LOWER RICHLAND BLVD

PO BOX 544

PO BOX 544

1203 E MULLER AVE

COLUMBIA, SC 29210-6130

HOPKINS, SC 29061-9525

BLYTHEWOOD, SC 29016-0544

BLYTHEWOOD, SC 29016-0544

COLUMBIA, SC 29203-5926

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

County/Ownership TypeMailing/Billing AddressLicensee

MARTIN DONALD E

PIEDMONT CENTER FOR MENTAL HEALTH SERVICES

THOMAS KATHERINE W

THOMAS KATHERINE W

REESE'S COMMUNITY CARE HOME 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

No

No

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

0

0

Page 16: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

16 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

REESE'S COMMUNITY CARE HOME #2

RICE ESTATE - ASSISTED LIVING

ROCKHAVEN COMMUNITY CARE HOME

ROUSE COMMUNITY CARE HOME #1

ROUSE COMMUNITY CARE HOME #2

PH#:

REAVIS LISA D PH#: 803-691-5720

BARNES RICHIE D PH#: 803-699-5361

ROUSE CHARLENE E PH#: 803-788-1753

ADDISON-DOCTOR SARAH PH#: 803-786-9357

5

40

10

8

9

717 CINDY DR

100 FINLEY RD

524 ROCKHAVEN DR

102 BALLENTON RD

8809 WILSON BLVD

Richland / Sole Proprietorship

Richland / Non-Profit Corporation

Richland / Sole Proprietorship

Richland / Corporation

Richland / Corporation

CRC-0054 / 03/31/2019

CRC-1075 / 03/31/2019

CRC-0800 / 01/31/2019

CRC-0327 / 12/31/2018 (Renewal Pending)

CRC-0328 / 12/31/2019

COLUMBIA, SC 29203-5205 FAC.#:803-908-3551

COLUMBIA, SC 29203-9264 FAC.#:803-691-5720

COLUMBIA, SC 29223-7805 FAC.#:803-699-5361

COLUMBIA, SC 29203-9073 FAC.#:803-788-1753

COLUMBIA, SC 29203-1817 FAC.#:803-786-9357

1203 MULLER AVE

300 MINISTRY DR

524 ROCKHAVEN DR

PO BOX 134

PO BOX 134

COLUMBIA, SC 29203

IRMO, SC 29063-2366

COLUMBIA, SC 29223-7805

STATE PARK, SC 29147-0134

STATE PARK, SC 29147-0134

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

County/Ownership TypeMailing/Billing AddressLicensee

REESE'S COMMUNITY CARE HOME INC

LUTHERAN HOMES OF SOUTH CAROLINA INC

RICHIE D BARNES

ROUSE COMMUNITY CARE HOME INC

ROUSE COMMUNITY CARE HOME 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

No

No

No

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

No

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

0

0

0

0

0

0

Page 17: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

17 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

ROUSE COMMUNITY CARE HOME #3

TURNING POINT CRCF

WALTERS RESIDENTIAL CARE

WESTSIDE RESIDENTIAL HOME

WILDEWOOD DOWNS ASSISTED LIVING COMMUNITY

ROUSE CHARLENE E PH#: 803-754-5720

DENNIS DORETHA L PH#: 803-647-1152

JOHNSON DELORES W PH#: 803-252-8918

JOHNSON LOVICE D PH#: 803-786-7411

CHAVIS DIANA L PH#: 803-788-5115

10

15

35

38

57

9316 WILSON BLVD

820 TOMS CREEK RD

821 DUKE AVE, 821-823

4112 HARTFORD ST

731 POLO RD

Richland / Corporation

Richland / State

Richland / Non-Profit Corporation

Richland / Corporation

Richland / Ltd. Liability

CRC-0238 / 09/30/2019

CRC-1356 / 04/30/2019

CRC-0985 / 03/31/2019

CRC-0907 / 11/30/2019

CRC-1271 / 03/31/2019

COLUMBIA, SC 29203-9769 FAC.#:803-754-5720

HOPKINS, SC 29061-8798 FAC.#:803-647-1152

COLUMBIA, SC 29203-5651 FAC.#:803-252-8918

COLUMBIA, SC 29204-3025 FAC.#:803-786-7411

COLUMBIA, SC 29223-4462 FAC.#:803-788-5115

PO BOX 134

820 TOMS CREEK RD

PO BOX 211263

PO BOX 7905

731 POLO RD

STATE PARK, SC 29147-0134

HOPKINS, SC 29061-8798

COLUMBIA, SC 29221-6263

COLUMBIA, SC 29202-7905

COLUMBIA, SC 29223-4462

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

County/Ownership TypeMailing/Billing AddressLicensee

ROUSE COMMUNITY CARE HOME INC

PIEDMONT CENTER FOR MENTAL HEALTH SERVICES

MIPD INC

WESTSIDE RESIDENTIAL HOME INC

WILDEWOOD DOWNS RETIREMENT 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

No

No

No

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

No

Yes

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Resident:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

Max # Beds:

0

0

0

0

8

0

0

0

0

8

Page 18: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

18 hlfactcc.rdf

RichlandCounty:

Community Residential Care FacilityFacility Type:

WILLIAMS COMMUNITY CARE HOME

WILLIAMS CHARLES A PH#: 803-783-1223

9

7705 RICHARD ST

Richland / Sole Proprietorship

CRC-0280 / 11/30/2019

COLUMBIA, SC 29209-3733 FAC.#:803-783-1223

8435 MONTICELLO RD

COLUMBIA, SC 29203

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 56 Number Licensed Units: 1,476

CHARLES A WILLIAMS SR

Totals For Facility/License Type: Community Residential Care Facility

Facility Email: [email protected]

Licensed

Units

Certifications:

Alzheimer Care:

None

NoAlzheimer Unit:No Max # Resident: Max # Beds:0 0

Page 19: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

19 hlfactcc.rdf

RichlandCounty:

Freestanding or Mobile Tech.Facility Type:

SOUTH CAROLINA ONCOLOGY ASSOCIATES PA-COLUMBIA

SHEALY DAWN PH#: 803-461-3600

1

166 STONERIDGE DR

Richland / Partnership

FSMT-0027 / 10/31/2019

COLUMBIA, SC 29210-8239 FAC.#:803-461-3627

166 STONERIDGE DR STE 100

COLUMBIA, SC 29210-8239

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: 1

SOUTH CAROLINA ONCOLOGY ASSOCIATES PA

Totals For Facility/License Type: Freestanding or Mobile Tech.

Facility Email: [email protected]

Licensed

Units

Page 20: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

20 hlfactcc.rdf

RichlandCounty:

Habilitation R15Facility Type:

ARCHIE DRIVE GROUP HOME

CARTER STREET GROUP HOME

HORRELL HILL COMMUNITY RESIDENCE

RABBIT RUN COMMUNITY RESIDENCE

WOODLAWN GROUP HOME

GASS ANISTE PH#: 803-799-1970

GASS ANISTE PH#: 803-799-1970

GASS ANISTE PH#: 803-799-1970

GASS ANISTE PH#: 803-799-1970

GASS ANISTE PH#: 803-799-1970

8

8

8

8

8

33 ARCHIE DR

1203 CARTER ST

1614 RIDGE RD

1114 RABBIT RUN RD

1400 WOODLAWN DR

Richland / State

Richland / State

Richland / State

Richland / State

Richland / State

MR15-0178 / 06/30/2019

MR15-0193 / 06/30/2019

MR15-0200 / 06/30/2019

MR15-0217 / 06/30/2019

MR15-0227 / 06/30/2019

COLUMBIA, SC 29223-5813 FAC.#:803-799-1970

COLUMBIA, SC 29204-2852 FAC.#:803-799-1970

HOPKINS, SC 29061 FAC.#:803-799-1970

HOPKINS, SC 29061 FAC.#:803-799-1970

COLUMBIA, SC 29209 FAC.#:803-799-1970

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

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: 40

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:

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 21: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

21 hlfactcc.rdf

RichlandCounty:

Habilitation R16Facility Type:

FIRST MIDLANDS ICF/IID

WRIGHT ANGELA PH#: 803-935-7502

344

8301 FARROW RD

Richland / State

MR16-0103 / 05/31/2019

COLUMBIA, SC 29203-3294 FAC.#:803-935-7502

PO BOX 4706, DDSN C/O DAVID GOODELL

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: 1 Number Licensed Units: 344

SOUTH CAROLINA DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS

Totals For Facility/License Type: Habilitation R16

Facility Email: [email protected]

Licensed

Units

Page 22: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

22 hlfactcc.rdf

RichlandCounty:

Home HealthFacility Type:

KINDRED AT HOME

PALMETTO HEALTH HOMECARE

PRESBYTERIAN COMMUNITIES OF SC HOME HEALTH AGENCY

BROWN NATASHA L PH#:

HEFLIN FRANK G PH#: 803-296-3100

STAMPER AMANDA L PH#: 803-772-5885

4

2

7

2000 CENTER POINT RD STE 2300

1400 PICKENS ST

2817 ASHLAND RD

Richland / Limited Liability

Richland / Non-Profit Corporation

Richland / Non-Profit Corporation

HHA-0154 / 11/30/2019

HHA-0148 / 02/28/2019

HHA-0212 / 12/31/2019

COLUMBIA, SC 29210-7318 FAC.#:803-731-2365

COLUMBIA, SC 29201-3465 FAC.#:803-296-3100

COLUMBIA, SC 29210-5009 FAC.#:803-772-5885

12900 FOSTER ST STE 400

PO BOX 7275

2817 ASHLAND RD

OVERLAND PARK, KS 66213-2696

COLUMBIA, SC 29202-7275

COLUMBIA, SC 29210-5009

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

County/Ownership TypeMailing/Billing AddressLicensee

CAPITAL CARE RESOURCES OF SOUTH CAROLINA LLC

PALMETTO HEALTH

PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA

Counties Served:

Counties Served:

Counties Served:

Calhoun, Lexington, Orangeburg, Richland

Lexington, Richland

Berkeley, Dorchester, Florence, Laurens, Lexington, Pickens, Richland, Special

Note - Berkeley, Dorchester, Florence, Laurens, Lexington Pickens & Richland CCRC

campus residents only

License Restrictions:

License Restrictions:

License Restrictions:SERVING CONTINUING CARE RETIREMENT COMMUNITY CAMPUSES ONLY IN 7 COUNTIES AS LI

Physical Therapy:

Physical Therapy:

Physical Therapy:

Y

Y

Y

Speech Therapy:

Speech Therapy:

Speech Therapy:

Y

Y

Y

Occupational Therapy:

Occupational Therapy:

Occupational Therapy:

Y

Y

Y

Med. Social Services:

Med. Social Services:

Med. Social Services:

Y

Y

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:

CHAPLAINEY, DIETARY AND ENTEROSTOMAL THERAPIST

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 23: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

23 hlfactcc.rdf

RichlandCounty:

Home HealthFacility Type:

PRUITTHEALTH HOME HEALTH-COLUMBIA

YOUNG STEPHANIE PH#: 803-359-2253

23

240 STONERIDGE DR STE 100

Richland / Corporation

HHA-0232 / 01/31/2019

COLUMBIA, SC 29210-8013 FAC.#:803-626-0089

118 YORK ST

CHESTER, SC 29706-1484

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 4 Number Licensed Units: 36

PRUITTHEALTH HOME HEALTH INC

Counties Served: Abbeville, Anderson, Calhoun, Cherokee, Chester, Edgefield, Fairfield, Greenville,

Greenwood, Kershaw, Lancaster, Laurens, Lexington, McCormick, Newberry, Oconee,

Pickens, Richland, Saluda, Spartanburg, Sumter, Union, York

Totals For Facility/License Type: Home Health

License Restrictions:

Physical Therapy: Y Speech Therapy: Y Occupational Therapy:Y Med. Social Services:YHome Health Aid: Y Medical Supplies/Appliances/Durable Medical Equipment: N

Other:

Facility Email: [email protected]

Licensed

Units

Page 24: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

24 hlfactcc.rdf

RichlandCounty:

Hospice FacilityFacility Type:

AGAPE HOSPICE HOUSE OF THE MIDLANDS

AGAPE HOSPICE HOUSE OF THE MIDLANDS

PIERCE JR R MAX PH#: 803-454-1221

DILLARD REBECCA J PH#: 803-776-4484

12

12

141 STONERIDGE DR

141 STONERIDGE DR

Richland / Corporation

Richland / Corporation

HPF-0034 / 11/30/2019

HPF-0026 / 04/30/2019

COLUMBIA, SC 29210-8240 FAC.#:803-454-1221

COLUMBIA, SC 29210-8240 FAC.#:803-454-1221

141 STONERIDGE DR

COLUMBIA, SC 29210-8240

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: 24

AGAPE HOSPICE OF THE LOW COUNTRY INC

AGAPE COMMUNITY HOSPICE OF THE GRAND STRAND INC

Totals For Facility/License Type: Hospice Facility

Facility Email:

Facility Email:

[email protected]

[email protected]

Licensed

Units

Page 25: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

25 hlfactcc.rdf

RichlandCounty:

Hospice ProgramFacility Type:

COMFORT CARE HOSPICE

COMPASSIONATE CARE HOSPICE OF SOUTH CAROLINA

CRESCENT HOSPICE

HADORA HOSPICE LLC

PH#:

THOMPSON JEREMY PH#: 803-731-8110

MORTON DANA PH#: 803-732-3274

GREEN WANDA PH#: 803-667-9012

31

46

46

6

2211 LAKE MURRAY BLVD

100 ASHLAND PARK LN STE B

1370 BROWNING RD STE 120

6156 SAINT ANDREWS RD STE 208

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

HPC-0183 / 06/30/2019

HPC-0156 / 10/31/2019

HPC-0160 / 06/30/2019

HPC-0217 / 12/31/2019

COLUMBIA, SC 29212 FAC.#:803-749-8080

COLUMBIA, SC 29210 FAC.#:803-731-8110

COLUMBIA, SC 29210 FAC.#:803-732-3274

COLUMBIA, SC 29212 FAC.#:803-667-9012

403 N LAKE DR

455 SAINT ANDREWS RD BLDG D STES 1 & 4A

1370 BROWNING RD STE 120

PO BOX 1671

LEXINGTON, SC 29072

COLUMBIA, SC 29210-4486

COLUMBIA, SC 29210

IRMO, SC 29063

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

County/Ownership TypeMailing/Billing AddressLicensee

COMFORT CARE HOSPICE LLC

COMPASSIONATE CARE HOSPICE OF SOUTH CAROLINA LLC

CRESCENT HOSPICE INC

LAWRIN GREEN

Counties Served:

Counties Served:

Counties Served:

Counties Served:

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

Charleston, Darlington, Dillon, Dorchester, Edgefield, Florence, Georgetown,

Greenville, Greenwood, Hampton, Horry, Laurens, Lexington, McCormick, Newberry,

Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union

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

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, Lee, Lexington, Orangeburg, Richland, Sumter

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 26: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

26 hlfactcc.rdf

RichlandCounty:

Hospice ProgramFacility Type:

HALCYON HOSPICE

HEARTFELT HOSPICE INC DBA HEARTSTRINGS HOSPICE

HOMESTEAD HOSPICE OF COLUMBIA

LIGHTHOUSE HOSPICE GROUP

HANNA EMILY J PH#: 803-758-4099

GUTSHALL MICHAEL S PH#: 803-699-3233

TILLEY BARBARA JEAN PH#: 803-509-8844

FROST NICOLE L PH#: 803-781-1935

46

17

46

7

140 STONERIDGE DR STE 630

115 BLARNEY DR STE 202A

7825 BROAD RIVER RD STE 100

110 OAK PARK DR STE C

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

HPC-0145 / 07/31/2019

HPC-0211 / 09/30/2019

HPC-0204 / 04/30/2019

HPC-0159 / 05/31/2019

COLUMBIA, SC 29210-8258 FAC.#:803-758-4099

COLUMBIA, SC 29223-6291 FAC.#:803-699-3233

IRMO, SC 29063-2375 FAC.#:803-509-8844

IRMO, SC 29063-6110 FAC.#:803-781-1935

PO BOX 51266

115 BLARNEY DR STE 202A

10888 CRABAPPLE RD

110 OAK PARK DR STE C

LAFAYETTE, LA 70505-1266

COLUMBIA, SC 29223-6291

ROSWELL, GA 30075-5850

IRMO, SC 29063-6110

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

County/Ownership TypeMailing/Billing AddressLicensee

LHCG XLI LLC

HEARTFELT HOSPICE INC

HOMESTEAD HOSPICE OF COLUMBIA LLC

LIGHTHOUSE HOSPICE GROUP LLC

Counties Served:

Counties Served:

Counties Served:

Counties Served:

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, Allendale, Bamberg, Barnwell, Calhoun, Edgefield, Fairfield, Greenwood,

Kershaw, Lee, Lexington, McCormick, Newberry, Orangeburg, Richland, Saluda, Sumter

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

Calhoun, Fairfield, Lexington, Newberry, Orangeburg, Richland, Sumter

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Page 27: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

27 hlfactcc.rdf

RichlandCounty:

Hospice ProgramFacility Type:

LUTHERAN HOSPICE

MEDICAL SERVICES OF AMERICA HOSPICE

PALMETTO HEALTH HOSPICE

PRUITTHEALTH HOSPICE-COLUMBIA

REST ASSURED FAMILY SERVICES

ESTES GREGORY A PH#: 803-749-7770

MCCLAIN EDNA M PH#: 803-400-1171

HEFLIN FRANK G PH#: 803-296-3100

DANKO LANCE PH#:

CARTER TRACEY M PH#: 803-788-8272

46

30

13

21

13

102 FORTRESS DR

166 STONERIDGE DR STE 100

1400 PICKENS ST

903 ELMWOOD AVE STE A

9570 TWO NOTCH RD STE 9

Richland / Non-Profit Corporation

Richland / Corporation

Richland / Non-Profit Corporation

Richland / Corporation

Richland / Non-Profit Corporation

HPC-0041 / 03/31/2019

HPC-0043 / 02/28/2019

HPC-0056 / 02/28/2019

HPC-0102 / 12/31/2019

HPC-0158 / 01/31/2019

CHAPIN, SC 29063 FAC.#:803-749-7770

COLUMBIA, SC 29210-8239 FAC.#:803-400-1171

COLUMBIA, SC 29201-3465 FAC.#:803-296-3100

COLUMBIA, SC 29201-2066 FAC.#:803-771-0489

COLUMBIA, SC 29223 FAC.#:803-788-8272

PO BOX 805

PO BOX 609

PO BOX 7275

903 ELMWOOD AVE STE A

9570 TWO NOTCH RD STE 9

WHITE ROCK, SC 29177-0805

LEXINGTON, SC 29071-0609

COLUMBIA, SC 29202-7275

COLUMBIA, SC 29201-2066

COLUMBIA, SC 29223

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

County/Ownership TypeMailing/Billing AddressLicensee

LUTHERAN HOMES OF SOUTH CAROLINA INC

TRI COUNTY HOSPICE INC

PALMETTO HEALTH

PRUITTHEALTH HOSPICE INC

REST ASSURED FAMILY SERVICES

Counties Served:

Counties Served:

Counties Served:

Counties Served:

Counties Served:

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

Abbeville, Aiken, Allendale, Bamberg, Barnwell, Calhoun, Chesterfield, Clarendon,

Darlington, Edgefield, Fairfield, Florence, Georgetown, Greenwood, Hampton,

Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, McCormick,

Newberry, Orangeburg, Richland, Saluda, Sumter, Union, Williamsburg

Aiken, Calhoun, Chester, Fairfield, Kershaw, Lancaster, Laurens, Lexington,

Newberry, Richland, Saluda, Sumter, Union

Abbeville, Anderson, Calhoun, Cherokee, Chester, Fairfield, Greenville, Greenwood,

Kershaw, Lancaster, Laurens, Lexington, Newberry, Oconee, Pickens, Richland,

Saluda, Spartanburg, Sumter, Union, York

Aiken, Bamberg, Barnwell, Calhoun, Clarendon, Fairfield, Kershaw, Lee, Lexington,

Newberry, Orangeburg, Richland, Sumter

Facility Email:

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected].

[email protected]

[email protected]

Licensed

Units

Page 28: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

28 hlfactcc.rdf

RichlandCounty:

Hospice ProgramFacility Type:

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 13 Number Licensed Units: 368

Totals For Facility/License Type: Hospice Program

Licensed

Units

Page 29: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

29 hlfactcc.rdf

RichlandCounty:

Hospital or Institutional General InfirmaryFacility Type:

CONTINUECARE HOSPITAL AT PALMETTO HEALTH BAPTIST

CORRECT CARE OF SOUTH CAROLINA

ENCOMPASS HEALTH REHABILITATION HOSPITAL OF COLUMBIA

G WERBER BRYAN PSYCHIATRIC HOSPITAL

PH#:

LAWRENZ JR RONALD R PH#: 803-935-0505

DAUGHTRY CHRIS PH#: 803-254-7777

SHIELDS STUART PH#:

35

145

96

530

TAYLOR AT MARION ST

7901 FARROW RD

2935 COLONIAL DR

220 FAISON DR

Richland / Corporation

Richland / Limited Liability

Richland / Corporation

Richland / State

HTL-0939 / 08/31/2019

HTL-0756 / 09/30/2019

HTL-0504 / 01/31/2019

HTL-0515 / 02/28/2019

COLUMBIA, SC 29220 FAC.#:803-296-3126

COLUMBIA, SC 29203-3220 FAC.#:803-935-0505

COLUMBIA, SC 29203-6811 FAC.#:803-254-7777

COLUMBIA, SC 29203-3210 FAC.#:803-935-7143

TAYLOR AT MARION ST

7901 FARROW RD

2935 COLONIAL DR

220 FAISON DR

COLUMBIA, SC 29220

COLUMBIA, SC 29203

COLUMBIA, SC 29203-6811

COLUMBIA, SC 29203-3210

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

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

General:

General:

General:

General:

35

145

0

0

Psychiatric:

Psychiatric:

Psychiatric:

Psychiatric:

0

0

0

530

Rehab:

Rehab:

Rehab:

Rehab:

0

0

96

0

Substance Abuse:

Substance Abuse:

Substance Abuse:

Substance Abuse:

0

0

0

0

Other Beds :

Other Beds :

Other Beds :

Other Beds :

NICU:

NICU:

NICU:

NICU:

0

0

0

0

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

0

0

0

0

CONTINUECARE HOSPITAL AT PALMETTO HEALTH BAPTISTINC

CORRECT CARE OF SOUTH CAROLINA

ENCOMPASS HEALTH REHABILITATION HOSPITAL OF COLUMBIA INC

SC DEPARTMENT OF MENTAL HEALTH

Facility Email:

Facility Email:

Facility Email:

Facility Email:

[email protected]

[email protected]

[email protected]

[email protected]

Licensed

Units

Certifications:

Certifications:

Certifications:

Certifications:

None

None

JCAHO Accredited

JCAHO Accredited

Page 30: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

30 hlfactcc.rdf

RichlandCounty:

Hospital or Institutional General InfirmaryFacility Type:

GILLIAM PSYCHIATRIC HOSPITAL

KIRKLAND CORRECTIONAL INSTITUTION INFIRMARY

MORRIS VILLAGE

PALMETTO HEALTH BAPTIST

PALMETTO HEALTH BAPTIST PARKRIDGE

DRAKE JAMES STONEY PH#: 803-896-2271

MULLINS DANIEL PH#: 803-896-8567

MCCONNELL GEORGE PH#: 803-935-7100

GATTMAN GREGORY B PH#: 803-296-5010

KEENE EMILIE PH#: 803-907-7011

82

24

174

352

76

4344 BROAD RIVER RD

4344 BROAD RIVER RD

610 FAISON DR

TAYLOR ST AT MARION ST

400 PALMETTO HEALTH PKWY

Richland / State

Richland / State

Richland / State

Richland / Non-Profit Corporation

Richland / Non-Profit Corporation

HTL-0431 / 10/31/2019

HTL-0385 / 10/31/2019

HTL-0516 / 05/31/2019

HTL-0739 / 02/28/2019

HTL-0913 / 03/31/2019

COLUMBIA, SC 29210-4010 FAC.#:803-896-2271

COLUMBIA, SC 29210-4010 FAC.#:803-896-8567

COLUMBIA, SC 29203-3218 FAC.#:803-935-7100

COLUMBIA, SC 29220 FAC.#:803-296-5010

COLUMBIA, SC 29212-1760 FAC.#:803-907-7011

4344 BROAD RIVER RD

PO BOX 21787

610 FAISON DR

1330 TAYLOR ST

400 PALMETTO HEALTH PKWY

COLUMBIA, SC 29210-4010

COLUMBIA, SC 29221-1787

COLUMBIA, SC 29203-3218

COLUMBIA, SC 29201-2943

COLUMBIA, SC 29212-1760

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

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

General:

General:

General:

General:

General:

0

24

11

287

76

Psychiatric:

Psychiatric:

Psychiatric:

Psychiatric:

Psychiatric:

82

0

0

55

0

Rehab:

Rehab:

Rehab:

Rehab:

Rehab:

0

0

0

0

0

Substance Abuse:

Substance Abuse:

Substance Abuse:

Substance Abuse:

Substance Abuse:

0

0

163

10

0

Other Beds :

Other Beds :

Other Beds :

Other Beds :

Other Beds :

NICU:

NICU:

NICU:

NICU:

NICU:

0

0

0

8

0

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

0

0

0

22

0

SC DEPT OF CORRECTIONS

SC DEPT OF CORRECTIONS

SC DEPARTMENT OF MENTAL HEALTH

PALMETTO HEALTH

PALMETTO HEALTH

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:

None

None

None

Abortions, Perinatal Level III, JCAHO Accredited

Abortions, Perinatal Level I, JCAHO Accredited

Page 31: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

31 hlfactcc.rdf

RichlandCounty:

Hospital or Institutional General InfirmaryFacility Type:

PALMETTO HEALTH RICHLAND

PROVIDENCE HEALTH

PROVIDENCE HEALTH - NORTHEAST

SOUTH CAROLINA SEXUALLY VIOLENT PREDATOR TREATMENT

PROGRAM

WILLOW LANE INFIRMARY

HAM JAY PH#:

CAMPBELL C SCOTT PH#: 803-256-5300

CAMPBELL C SCOTT PH#: 803-865-4500

PH#:

TAVELLA PATRICK A PH#: 803-896-9461

641

258

74

14

8

5 RICHLAND MEDICAL PARK DR

2435 FOREST DR

120 GATEWAY CORPORATE BLVD

4546 BROAD RIVER RD

4650 BROAD RIVER RD

Richland / Non-Profit Corporation

Richland / Limited Liability

Richland / Limited Liability

Richland /

Richland / State

HTL-0741 / 02/28/2019

HTL-0928 / 02/28/2019

HTL-0929 / 02/28/2019

HTL-0942 / 12/31/2019

HTL-0274 / 06/30/2019

COLUMBIA, SC 29203-6897 FAC.#:803-434-7000

COLUMBIA, SC 29204-2098 FAC.#:803-256-5300

COLUMBIA, SC 29203-9611 FAC.#:803-865-4500

COLUMBIA, SC 29210 FAC.#:000-000-0000

COLUMBIA, SC 29210-4016 FAC.#:803-896-9461

1330 TAYLOR ST

2435 FOREST DR

120 GATEWAY CORPORATE BLVD

4546 BROAD RIVER RD

4650 BROAD RIVER RD

COLUMBIA, SC 29201-2943

COLUMBIA, SC 29204

COLUMBIA, SC 29203-9611

COLUMBIA, SC 29210

COLUMBIA, SC 29210-4016

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

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

Licensed Beds:

General:

General:

General:

General:

General:

579

258

74

14

8

Psychiatric:

Psychiatric:

Psychiatric:

Psychiatric:

Psychiatric:

52

0

0

0

0

Rehab:

Rehab:

Rehab:

Rehab:

Rehab:

0

0

0

0

0

Substance Abuse:

Substance Abuse:

Substance Abuse:

Substance Abuse:

Substance Abuse:

10

0

0

0

0

Other Beds :

Other Beds :

Other Beds :

Other Beds :

Other Beds :

NICU:

NICU:

NICU:

NICU:

NICU:

31

0

0

0

0

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

Neonatal Special Care:

38

0

0

0

0

PALMETTO HEALTH

PROVIDENCE HOSPITAL LLC

PROVIDENCE HOSPITAL LLC

CORRECT CARE OF SOUTH CAROLINA LLC

SC DEPARTMENT OF JUVENILE JUSTICE

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:

Abortions, Trauma Center Level I, Perinatal Level III Regional, JCAHO Accredited

JCAHO Accredited

JCAHO Accredited

None

None

Page 32: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

32 hlfactcc.rdf

RichlandCounty:

Hospital or Institutional General InfirmaryFacility Type:

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 14 Number Licensed Units: 2,509

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

Licensed

Units

Page 33: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

33 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

A TREE OF LIFE HOME CARE SVC

ABOUNDING ANGELS HEALTH CARE LLC

ACCESS HEALTH CARE SERVICES INC OF COLUMBIA

ACTIKARE

ACTS: OF LOVE HOME CARE AGENCY

ADDUS HOME CARE - COLUMBIA

ALL STATE HOME CARE LLC

ALLSTAR LLC

PH#:

PH#:

PH#:

PH#:

ROBERTSON DIMETRIUS PH#: 803-622-3813

PH#:

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

6941 N TRENHOLM RD STE F-105

9153C TWO NOTCH RD

106 DOCTOR CIR

354 POETS WALK

101 RICE BENT WAY UNIT 3

1612 MARION ST STE 103

2000 MOCKINGBIRD RD

1411 RIVERWALK WAY

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

IHCP-0728 / 06/30/2019

IHCP-0279 / 08/31/2019

IHCP-0110 / 04/30/2019

IHCP-0355 / 05/31/2019

IHCP-0700 / 06/30/2019

IHCP-0195 / 06/30/2019

IHCP-0198 / 06/30/2019

IHCP-0736 / 11/30/2018 (Renewal Pending)

COLUMBIA, SC 29206 FAC.#:803-828-4473

COLUMBIA, SC 29223-5832 FAC.#:803-223-9178

COLUMBIA, SC 29203-6503 FAC.#:803-509-8206

IRMO, SC 29063 FAC.#:803-238-2968

COLUMBIA, SC 29229 FAC.#:803-661-9642

COLUMBIA, SC 29201-2939 FAC.#:803-758-4000

COLUMBIA, SC 29204-3123 FAC.#:803-351-7554

IRMO, SC 29063 FAC.#:803-522-8858

11 OBERON PL

PO BOX 23659

PO BOX 3580

354 POETS WALK

1 SWEET KNOLL CT

2300 WARRENVILLE RD STE 100

2000 MOCKINGBIRD RD

1411 RIVERWALK WAY

COLUMBIA, SC 29223

COLUMBIA, SC 29224-3659

COLUMBIA, SC 29230-3580

IRMO, SC 29063

COLUMBIA, SC 29229

DOWNERS GROVE, IL 60515-1700

COLUMBIA, SC 29204-3123

IRMO, SC 29063

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

County/Ownership TypeMailing/Billing AddressLicensee

TREE OF LIFE IN-HOME CARE AND SVCS LLC

TROY D BELTON

ACCESS HEALTH CARE SERVICES INC

ALIGNED CONSULTING LLC

ACTS: OF LOVE HOME CARE AGENCY LLC

ADDUS HEALTHCARE (SOUTH CAROLINA) INC DBA ADDUS HOME CARE

ALL STATE HOME CARE LLC

ALLSTAR HOME HEALTH 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 34: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

34 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

ALWAYS BEST CARE OF THE MIDLANDS

AMERICARE LLC

ANDERSON HOME CARE

ANNI B'S IN HOME CARE

ASSISTED CARE SERVICES INC

BAYADA HOME CARE - COLUMBIA INC

BENEVOLANCE HOME CARE

BRIGHTSTAR CARE OF COLUMBIA

PH#:

PH#:

PH#:

PH#:

KILGORE ANNA J PH#: 803-400-1601

PH#:

PH#:

NEELEY BRIAN PH#: 803-772-2222

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

3800 FOREST DR STE C-201

619 CHATHAM AVE

10 CRANLEY CT

1612 MARION ST STE 329

2700 MIDDLEBURG DR STE 217

900 ELMWOOD AVE STE 101 & 103

1322 KINGSVILLE RD

1701 DEVONSHIRE DR STE 102

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Corporation

Richland / Limited Liability

Richland /

IHCP-0058 / 01/31/2019

IHCP-0550 / 06/30/2019

IHCP-0715 / 07/31/2019

IHCP-0839 / 05/31/2019

IHCP-0602 / 12/31/2019

IHCP-0186 / 06/30/2019

IHCP-0935 / 11/30/2019

IHCP-0918 / 08/31/2019

COLUMBIA, SC 29204 FAC.#:803-403-1895

COLUMBIA, SC 29205 FAC.#:803-765-4616

COLUMBIA, SC 29229 FAC.#:888-513-5972

COLUMBIA, SC 29201 FAC.#:516-456-5445

COLUMBIA, SC 29204 FAC.#:803-400-1601

COLUMBIA, SC 29201 FAC.#:803-252-1004

GADSDEN, SC 29052 FAC.#:803-647-9321

COLUMBIA, SC 29204 FAC.#:803-760-0517

3800 FOREST DR STE C-201

619 CHATHAM AVE

10 CRANLEY CT

2700 MIDDLEBURG DR STE 217

1226 PICKENS ST STE 103

COLUMBIA, SC 29204

COLUMBIA, SC 29205

COLUMBIA, SC 29229

COLUMBIA, SC 29204

COLUMBIA, SC 29201

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

County/Ownership TypeMailing/Billing AddressLicensee

NLR SERVICES INC

AMERICARE LLC

ANDERSON HOME HEALTH CARE LLC

ANNI B'S IN HOME CARE LLC

ASSISTED CARE SERVICES INC

BAYADA HOME HEALTH CARE INC

THE H DOWDY & 13TH LLC

BEVERLY HOME HEALTHCARE SERVICES

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 35: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

35 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

BROTHER2BROTHER HOMECARE SERVICES

CAMRYN'S VILLAGE

CAROLINA HEALTH CARE

CAROLINA IN HOME CARE & ASSISTANCE

CASANIA'S CARING HANDS

CHEERS TRANSITIONAL SERVICES CENTER INC

CIRCLE OF LIFE HOME CARE SERVICE

COMFORCARE OF THE MIDLANDS

PH#:

PHELPS LAHARTHA S PH#:

EDMONDS LAREECE PH#: 803-256-2728

PH#:

GLOVER LASHAUNDA PH#: 803-667-0699

MOUNTAIN JULIA PH#:

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

1 WINDSOR COVE STE 306

305 OLD BRASS DR

1403 CALHOUN ST

2210 ROSEWOOD DR

1113 BELLEVIEW ST STE 105

421 BUSH RIVER RD UNIT 208

1919 HAMPTON ST

22 OFFICE PARK CT STE C

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Corporation

IHCP-0297 / 07/31/2019

IHCP-0814 / 03/31/2019

IHCP-0745 / 05/31/2019

IHCP-0147 / 05/31/2019

IHCP-0627 / 01/31/2019

IHCP-0324 / 08/31/2019

IHCP-0804 / 12/31/2018 (Renewal Pending)

IHCP-0236 / 07/31/2019

COLUMBIA, SC 29223 FAC.#:803-699-2226

COLUMBIA, SC 29229 FAC.#:803-888-0482

COLUMBIA, SC 29201 FAC.#:803-256-2728

COLUMBIA, SC 29205-3743 FAC.#:803-318-4276

COLUMBIA, SC 29201 FAC.#:803-667-0699

COLUMBIA, SC 29210-7333 FAC.#:803-727-2572

COLUMBIA, SC 29201 FAC.#:803-806-5533

COLUMBIA, SC 29223-5965 FAC.#:803-764-0231

PO BOX 23806

1643 B SAVANNAH HWY STE 205

2210 ROSEWOOD DR

421 BUSH RIVER RD

22 OFFICE PARK CT STE C

COLUMBIA, SC 29223

CHARLESTON, SC 29407

COLUMBIA, SC 29205-3743

COLUMBIA, SC 29210

COLUMBIA, SC 29223-5965

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

County/Ownership TypeMailing/Billing AddressLicensee

BROTHER2BROTHER LLC

CAMRYN'S VILLAGE LLC

HALE OLA LLC

CBX ONE-STOP LLC

CASANIA'S CARING HANDS LLC

CHEERS TRANSITIONAL SERVICES CENTER INC

CIRCLE OF LIFE HOME CARE SERVICE LLC

BOOKIEBUGS 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 36: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

36 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

COMPLETE HOME CARE SERVICES LLC

CONNECTED HEARTS HOME CARE LLC

CORPORATE CARE LLC-COLUMBIA

CREATIVE HOME CARE LLC

DEVOTED CARE AND TRANSITION SERVICES LLC

ESPEY HOME CARE LLC

FIRST PRIORITY HOME CARE LLC

GENTLE HEARTS IN HOME CARE INC

PH#:

CLAIBOURN LANESE N PH#:

PH#:

PH#:

PH#:

LOGAN ANGELA PH#: 803-851-5973

PH#:

METTS-SHEFFIELD RHONDA PH#: 803-750-6200

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

5223 TWO NOTCH RD STE 1

3924 FOREST DR STE 9

1620 BROAD RIVER RD

7356 GARNERS FERRY RD STE 212

2821 ASHLAND RD STE C

1720 DEVONSHIRE DR APT 324

111 WILDEWOOD PARK DR

1345 GARNER LN 301

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

IHCP-0511 / 08/31/2019

IHCP-0311 / 08/31/2019

IHCP-0288 / 08/31/2019

IHCP-0332 / 11/30/2019

IHCP-0117 / 04/30/2019

IHCP-0936 / 12/31/2019

IHCP-0099 / 04/30/2019

IHCP-0327 / 09/30/2019

COLUMBIA, SC 29204-2940 FAC.#:803-391-8843

COLUMBIA, SC 29204 FAC.#:844-443-9500

COLUMBIA, SC 29210 FAC.#:803-403-1986

COLUMBIA, SC 29209-2146 FAC.#:803-776-9105

COLUMBIA, SC 29210 FAC.#:803-764-1163

COLUMBIA, SC 29204 FAC.#:803-851-5973

COLUMBIA, SC 29223 FAC.#:803-661-8805

COLUMBIA, SC 29210 FAC.#:803-750-6200

PO BOX 24642

3924 FOREST DR STE 9

PO BOX 16148

7356 GARNERS FERRY RD STE 212

2821 ASHLAND RD STE C

PO BOX 23781

1345 GARNER LN 301

COLUMBIA, SC 29224-4642

COLUMBIA, SC 29204

GREENVILLE, SC 29606-7148

COLUMBIA, SC 29209-2146

COLUMBIA, SC 29210

COLUMBIA, SC 29224

COLUMBIA, SC 29210

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

County/Ownership TypeMailing/Billing AddressLicensee

COMPLETE HOME CARE SERVICES LLC

NIGHTINGALE COMMUNITY HOME CARE LLC

CORPORATE CARE LLC

CREATIVE HOME CARE LLC

DEVOTED CARE AND TRANSITION SERVICES LLC

ESPEY HOME CARE LLC

FIRST PRIORITY HOME CARE LLC

GENTLE HEARTS HOME CARE 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 37: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

37 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

GOOD DEEDS HOME CARE LLC

GRACIOUS HANDS HOME CARE LLC

HEALTHCARE ETC LLC

HEARTFELT HOME CARE LLC

HEAVEN SENT HELPERS LLC

HELPING HANDS CAREGIVERS LLC

HOLISTIC HEALTH ADVANCEMENTS

HOME INSTEAD SENIOR CARE OF COLUMBIA

PH#:

SANDERS DEE PH#: 803-730-3006

SQUIREWELL VALARIE PH#: 803-708-4750

PH#:

PH#:

MUIR ANDRE PH#:

MULLINS MELISSA PH#: 803-205-5395

EDMONDS JASON T PH#: 864-879-7311

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

3905 W BELTLINE BLVD

108 COPPER RIDGE RD

7340 PARKLANE RD STE 101

6236 ST ANDREWS RD STE 2

1825 SAINT JULIAN PL STE F3

9400 TWO NOTCH RD STE C

9005 TWO NOTCH RD STE 4

9367 TWO NOTCH RD STE C

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

IHCP-0168 / 05/31/2019

IHCP-0626 / 09/30/2019

IHCP-0639 / 10/31/2019

IHCP-0560 / 05/31/2019

IHCP-0169 / 05/31/2019

IHCP-0156 / 05/31/2019

IHCP-0969 / 12/31/2019

IHCP-0869 / 07/31/2019

COLUMBIA, SC 29204 FAC.#:803-764-4750

COLUMBIA, SC 29212 FAC.#:803-730-3006

COLUMBIA, SC 29223 FAC.#:803-708-4750

COLUMBIA, SC 29212 FAC.#:803-331-3391

COLUMBIA, SC 29204-2424 FAC.#:803-446-3151

COLUMBIA, SC 29223-5946 FAC.#:803-699-1016

COLUMBIA, SC 29223 FAC.#:803-205-5395

COLUMBIA, SC 29223-6450 FAC.#:803-736-4242

3905 W BELTLINE BLVD

108 COPPER RIDGE RD

7340 PARKLANE RD STE 101

6236 ST ANDREWS RD STE 2

1825 SAINT JULIAN PL STE F3

9400 TWO NOTCH RD STE C

COLUMBIA, SC 29204

COLUMBIA, SC 29212

COLUMBIA, SC 29223

COLUMBIA, SC 29212

COLUMBIA, SC 29204-2424

COLUMBIA, SC 29223-5946

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

County/Ownership TypeMailing/Billing AddressLicensee

THE HAVENS ENTERPRISE LLC

GRACIOUS HANDS HOME CARE LLC

HEALTHCARE ETC LLC

HEARTFELT HOME CARE LLC

HEAVEN SENT HELPERS LLC

HELPING HANDS CAREGIVERS LLC

HOLISTIC HEALTH ADVANCEMENTS LLC

BJRSC 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 38: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

38 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

HOME WATCH CAREGIVERS OF COLUMBIA

INFINITY ONE HEALTHCARE

INTERIM HEALTHCARE-COLUMBIA

KARING IN MIND LLC

KENNEDY'S ASSISTIVE LIVING & EDUCATIONAL FACILITY

(KALEF)

LIGHTHOUSE PROFESSIONAL STAFFING INC

LIVE LOVE & LAUGH - HOME CARE SERVICES

LOVE & CARE HOME CARE AGENCY

THURMOND TERESA PH#: 803-708-2252

PH#:

PH#:

PH#:

PH#:

PH#:

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

115 ATRIUM WAY STE 211

3031 SCOTSMAN RD STE 5

1103 BELLEVIEW ST STE 103

7356 GARNERS FERRY RD STE 113

1941 DECKER BLVD

4500 FORT JACKSON BLVD

5 LIPPWELL CT

7357 PARKLANE RD

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland /

Richland / Sole Proprietorship

Richland / Corporation

Richland /

Richland / Limited Liability

IHCP-0927 / 09/30/2019

IHCP-0395 / 04/30/2019

IHCP-0116 / 04/30/2019

IHCP-0072 / 03/31/2019

IHCP-0158 / 05/31/2019

IHCP-0190 / 06/30/2019

IHCP-0876 / 06/30/2019

IHCP-0083 / 03/31/2019

COLUMBIA, SC 29223 FAC.#:803-339-8899

COLUMBIA, SC 29223 FAC.#:803-465-9085

COLUMBIA, SC 29201-1871 FAC.#:843-569-5510

COLUMBIA, SC 29209-2146 FAC.#:803-783-6039

COLUMBIA, SC 29206-3470 FAC.#:803-736-5872

COLUMBIA, SC 29209 FAC.#:803-782-1008

COLUMBIA, SC 29229 FAC.#:803-361-7797

COLUMBIA, SC 29223-7615 FAC.#:803-708-4730

PO BOX 362

1103 BELLEVIEW ST STE 103

136 FIELD PINE AVE

1941 DECKER BLVD

PO BOX 90506

7357 PARKLANE RD

COLUMBIA, SC 29202-0362

COLUMBIA, SC 29201-1871

HOPKINS, SC 29061

COLUMBIA, SC 29206-3470

CHARLESTON, SC 29410

COLUMBIA, SC 29223-7615

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

County/Ownership TypeMailing/Billing AddressLicensee

WHERE IT MATTERS LLC

INFINITY ONE CORPORATION INC

LOWCOUNTRY NURSING GROUP LLC

KARING IN MIND LLC

KENNEDY'S ASSISTIVE LIVING & EDUCATIONAL FACILITY (KALEF)

LIGHTHOUSE PROFESSIONAL STAFFING INC

LIVE LOVE & LAUGH - HOME CARE SERVICES LLC

LOVE & CARE HOME HEALTHCARE AGENCY 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 39: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

39 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

METRO HOME CARE LLC

NEW BRIDGE HOMECARE SERVICES LLC

NEW HOME CARE LLC

NURSES ARE US INC

PALMETTO CARE BEARS

PALMETTO HEALTH PRIVATE SERVICES

PALMETTO PERSONAL & SENIOR CARE

PALMETTO SOUTHERN COMFORT RESIDENTIAL CARE

DUPONT LISA PH#: 803-731-4400

PH#:

PH#:

PH#:

JOHNSON GERARD PH#: 803-569-0641

HEFLIN FRANK G PH#: 803-296-3100

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

1509 LADY ST STE B & G

7340 PARKLANE RD STE 202-B

104 MANN RD

3309 N MAIN ST

117 ALPINE CIR STE 600-B

1400 PICKENS ST

16 WILLOW WIND LN

3031 SCOTSMAN RD STE 16

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

IHCP-0631 / 12/31/2018 (Renewal Pending)

IHCP-0665 / 01/31/2019

IHCP-0489 / 11/30/2019

IHCP-0417 / 07/31/2019

IHCP-0697 / 03/31/2019

IHCP-0067 / 02/28/2019

IHCP-0726 / 06/30/2019

IHCP-0939 / 10/31/2019

COLUMBIA, SC 29201 FAC.#:803-253-8800

COLUMBIA, SC 29223 FAC.#:803-814-2493

COLUMBIA, SC 29223-8017 FAC.#:803-767-3374

COLUMBIA, SC 29203 FAC.#:803-799-3999

COLUMBIA, SC 29223 FAC.#:803-569-0641

COLUMBIA, SC 29201-3465 FAC.#:803-296-3100

HOPKINS, SC 29061 FAC.#:803-828-3231

COLUMBIA, SC 29223 FAC.#:803-369-2133

1509 LADY ST STE B & G

7340 PARKLANE RD STE 202-B

104 MANN RD

3309 N MAIN ST

120 PALMETTO PARK CIR

PO BOX 7275

16 WILLOW WIND LN

COLUMBIA, SC 29201

COLUMBIA, SC 29223

COLUMBIA, SC 29223-8017

COLUMBIA, SC 29203

COLUMBIA, SC 29229

COLUMBIA, SC 29202-7275

HOPKINS, SC 29061

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

County/Ownership TypeMailing/Billing AddressLicensee

METRO HOME CARE LLC

NEW BRIDGE HOMECARE SERVICES LLC

NEW HOME CARE LLC

NURSES ARE US INC

PALMETTO CARE BEARS HOME HEALTH CARE LLC

PALMETTO HEALTH

PALMETTO PERSONAL AND SENIOR CARE LLC

PALMETTO SOUTHERN COMFORT RESIDENTIAL CARE 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 40: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

40 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

PATRICIA

PRECIOUS HOME CARE SERVICES

PREMIER HOME CARE

PROCARE HOME CARE

QUALITY CARE SERVICES

RESCARE HOMECARE COLUMBIA

RESILIENCE HOMECARE

REST ASSURED LLC

PH#:

PH#:

LOUIS-JEAN PASCALE PH#: 803-708-2405

GREENE ANGELINA PH#: 803-708-7100

PH#:

YOUNG SHIRLEY PH#:

PH#:

PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

1332 MAIN ST STE 218

7356 GARNERS FERRY RD STE 119

8311 TWO NOTCH RD

1624 DECKER BLVD

5210 TWO NOTCH RD STE A

455 SAINT ANDREWS RD BLDG A STE 1

204 LAWAND DR

101 RICE BENT WAY STE 8

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Corporation

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

IHCP-0827 / 01/31/2019

IHCP-0143 / 05/31/2019

IHCP-0788 / 12/31/2018 (Renewal Pending)

IHCP-0657 / 01/31/2020

IHCP-0212 / 06/30/2019

IHCP-0170 / 06/30/2019

IHCP-0077 / 03/31/2019

IHCP-0238 / 07/31/2019

COLUMBIA, SC 29201 FAC.#:803-542-7776

COLUMBIA, SC 29209-2146 FAC.#:803-708-0716

COLUMBIA, SC 29223 FAC.#:803-708-2405

COLUMBIA, SC 29206 FAC.#:803-708-7100

COLUMBIA, SC 29204-2942 FAC.#:803-786-5919

COLUMBIA, SC 29210-4487 FAC.#:803-772-3060

COLUMBIA, SC 29210 FAC.#:803-667-9921

COLUMBIA, SC 29229-6850 FAC.#:803-865-8113

1332 MAIN ST STE 218

7356 GARNERS FERRY RD STE 119

18 KEENELAND TRAIL

1624 DECKER BLVD

PO BOX 25215

455 SAINT ANDREWS RD BUILDING A STE 1

204 LAWAND DR

101 RICE BENT WAY STE 8

COLUMBIA, SC 29201

COLUMBIA, SC 29209-2146

BLYTHEWOOD, SC 29016

COLUMBIA, SC 29206

COLUMBIA, SC 29224-5215

COLUMBIA, SC 29210

COLUMBIA, SC 29210

COLUMBIA, SC 29229-6850

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

County/Ownership TypeMailing/Billing AddressLicensee

PATRICIA LLC

PRECIOUS HOME CARE SERVICES

PREMIER HOME CARE LLC

PROCARE HOMECARE INC

QUALITY CARE SERVICES INC

SOUTHERN HOME CARE SERVICES INC

RESILIENCE HOMECARE LLC

REST ASSURED 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 41: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

41 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

RESTORATIVE HEALTH SERVICES OF SC LLC

ROBINSON S HEALING - HEARTS ASSISTED LIVING LLC

SENIOR MATTERS EXTENDED SERVICES

SENIOR RESOURCES

SHADES OF LIFE LLC

SHELIA'S HELPING HANDS

SITTING WITH AN ANGEL

SOUTH CAROLINA HOME CARE PROVIDER

PH#:

PH#:

MILLER KATHERINE PH#:

PH#:

ROBINSON CAROLYN PH#: 803-667-9819

PH#:

PH#:

MATHUR BHAWANA PH#:

- 1

- 1

- 1

- 1

- 1

- 1

- 1

- 1

2 OFFICE PARK CT STE 201C

7340 PARKLANE RD

3710 LANDMARK DR STE 109

2817 MILLWOOD AVE

1400 LAUREL ST STE 2

19 EASTBOURNE CT

455 ST ANDREWS RD BLDG D STE 4C

7340 PARKLANE RD STE 204C

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Corporation

Richland / Limited Liability

Richland / Limited Liability

Richland / Sole Proprietorship

Richland / Corporation

IHCP-0435 / 09/30/2019

IHCP-0437 / 04/30/2019

IHCP-0443 / 09/30/2019

IHCP-0059 / 02/28/2019

IHCP-0295 / 08/31/2019

IHCP-0938 / 12/31/2019

IHCP-0628 / 09/30/2019

IHCP-0389 / 10/31/2019

COLUMBIA, SC 29223-5966 FAC.#:803-828-4554

COLUMBIA, SC 29223 FAC.#:803-509-4769

COLUMBIA, SC 29204 FAC.#:803-779-1181

COLUMBIA, SC 29205-1261 FAC.#:803-252-7734

COLUMBIA, SC 29201 FAC.#:803-667-9819

COLUMBIA, SC 29223 FAC.#:803-587-1008

COLUMBIA, SC 29210 FAC.#:803-851-7268

COLUMBIA, SC 29223-7644 FAC.#:803-606-8289

2 OFFICE PARK CT STE 102

PO BOX 3991

3710 LANDMARK DR STE 109

2817 MILLWOOD AVE

1400 LAUREL ST STE 2

455 ST ANDREWS RD BLDG D STE 4C

1 DUNNOCK CT

COLUMBIA, SC 29223-5966

WEST COLUMBIA, SC 29171-3991

COLUMBIA, SC 29204

COLUMBIA, SC 29205-1261

COLUMBIA, SC 29202

COLUMBIA, SC 29210

COLUMBIA, SC 29229-9525

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

County/Ownership TypeMailing/Billing AddressLicensee

RESTORATIVE HEALTH SERVICES OF SC LLC

ROBINSON S HEALING - HEARTS ASSISTED LIVING LLC

SENIOR MATTERS EXTENDED SERVICES LLC

SENIOR RESOURCES INC

SHADES OF LIFE LLC

SHELIA'S HELPING HANDS LLC

THOMPSON ANDRENA

HINDH CORPORATION

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 42: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

42 hlfactcc.rdf

RichlandCounty:

Inhome Care ProviderFacility Type:

TAILORED LIFE CARE

TENDER KARE SERVICES II LLC

PH#:

PH#:

- 1

- 1

108 GLENEAGLE CIR

3905 W BELTLINE BLVD STE 5

Richland / Limited Liability

Richland / Limited Liability

IHCP-0841 / 03/31/2019

IHCP-0469 / 12/31/2018 (Renewal Pending)

IRMO, SC 29063 FAC.#:803-240-8591

COLUMBIA, SC 29204 FAC.#:803-638-9993

108 GLENEAGLE CIR

4443 BETHEL CHURCH RD APT 37

IRMO, SC 29063

COLUMBIA, SC 29206-1264

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 74 Number Licensed Units: - 74

TAILORED LIFE CARE LLC

TENDER KARE SERVICES II LLC

Totals For Facility/License Type: Inhome Care Provider

Facility Email:

Facility Email:

[email protected]

[email protected]

Licensed

Units

Page 43: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

43 hlfactcc.rdf

RichlandCounty:

Nursing HomeFacility Type:

C M TUCKER JR NURSING CARE CENTER FEWELL AND STONE

PAVILIONS

C M TUCKER JR NURSING CARE CENTER RODDEY PAVILION

COUNTRYWOOD NURSING CENTER

HEARTLAND OF COLUMBIA REHABILITATION AND NURSING

CENTER

MORGAN ROBERT PH#: 803-737-5399

JONES TED P PH#: 803-737-5301

HUNT JOSEPH R PH#: 803-776-3873

JENKINS HAZEL B PH#: 803-256-4983

252

308

38

132

2200 HARDEN ST

2200 HARDEN ST

1645 RIDGE RD

2601 FOREST DR

Richland / State

Richland / State

Richland / Ltd. Liability

Richland / Limited Liability

NCF-0334 / 12/31/2019

NCF-0726 / 12/31/2018 (Renewal Pending)

NCF-0946 / 11/30/2019

NCF-0316 / 12/31/2019

COLUMBIA, SC 29203-7199 FAC.#:803-737-5399

COLUMBIA, SC 29203-7199 FAC.#:803-737-5301

HOPKINS, SC 29061-8432 FAC.#:803-776-3873

COLUMBIA, SC 29204-2363 FAC.#:803-256-4983

2200 HARDEN ST

2200 HARDEN ST

1645 RIDGE RD

2601 FOREST DR

COLUMBIA, SC 29203-7199

COLUMBIA, SC 29203-7199

HOPKINS, SC 29061-8432

COLUMBIA, SC 29204-2363

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:

252

308

38

132

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

0

0

0

0

SC DEPARTMENT OF MENTAL HEALTH

SC DEPARTMENT OF MENTAL HEALTH

COUNTRYWOOD NURSING CENTER LLC

COLUMBIA REHABILITATION AND NURSING CENTER - COLUMBIA SC 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

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

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 44: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

44 hlfactcc.rdf

RichlandCounty:

Nursing HomeFacility Type:

HERITAGE AT LOWMAN REHABILITATION AND HEALTHCARE

LIFE CARE CENTER OF COLUMBIA

MIDLANDS HEALTH & REHABILITATION CENTER

NHC HEALTHCARE PARKLANE

HYMAN ASHLEY PH#: 803-732-3000

STUDNICKA STEPHANIE D PH#: 803-865-1999

STANLEY MATT PH#: 803-699-4111

ARGO MELISSA B PH#: 803-741-9090

176

179

88

180

201 FORTRESS DR

2514 FARAWAY DR

1007 N KINGS ST

7601 PARKLANE RD

Richland / Non-Profit Corporation

Richland / Corporation

Richland / Ltd. Liability

Richland / Ltd. Liability

NCF-0688 / 05/31/2019

NCF-0634 / 06/30/2019

NCF-0868 / 08/31/2019

NCF-0797 / 06/30/2019

CHAPIN, SC 29036 FAC.#:803-732-3000

COLUMBIA, SC 29223-3969 FAC.#:803-865-1999

COLUMBIA, SC 29223-1916 FAC.#:803-699-4111

COLUMBIA, SC 29223-6122 FAC.#:803-741-9090

PO BOX 444

2514 FARAWAY DR

1007 N KINGS ST

7601 PARKLANE RD

WHITE ROCK, SC 29177-0444

COLUMBIA, SC 29223-3969

COLUMBIA, SC 29223-1916

COLUMBIA, SC 29223-6122

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:

176

179

88

180

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

0

0

0

0

LUTHERAN HOMES OF SOUTH CAROLINA INC

RCM-COLUMBIA INC

THI OF SOUTH CAROLINA AT COLUMBIA LLC

NHC HEALTHCARE/PARKLANE 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

No

Yes

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

Yes

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 45: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

45 hlfactcc.rdf

RichlandCounty:

Nursing HomeFacility Type:

PRUITTHEALTH-BLYTHEWOOD

PRUITTHEALTH-COLUMBIA

RICE ESTATE REHABILITATION AND HEALTHCARE

WHITE OAK MANOR COLUMBIA

WASHBURN YVONNE PH#: 803-382-2300

LEE PATRICIA PH#: 803-254-5960

REAVIS LISA D PH#: 803-691-5720

NEAL MICHAEL S PH#: 803-782-4363

120

185

80

120

1075 HEATHER GREEN DR

2451 FOREST DR

100 FINLEY RD

3001 BEECHAVEN RD

Richland / Corporation

Richland / Limited Liability

Richland / Non-Profit Corporation

Richland / Corporation

NCF-0959 / 08/31/2019

NCF-0880 / 01/31/2019

NCF-0831 / 05/31/2019

NCF-0886 / 12/31/2019

COLUMBIA, SC 29229-7831 FAC.#:803-382-2300

COLUMBIA, SC 29204-2026 FAC.#:803-254-5960

COLUMBIA, SC 29203-9264 FAC.#:803-691-5720

COLUMBIA, SC 29204-2701 FAC.#:803-782-4363

1075 HEATHER GREEN DR

2451 FOREST DR

100 FINLEY RD

3001 BEECHAVEN RD

COLUMBIA, SC 29229-7831

COLUMBIA, SC 29204-2026

COLUMBIA, SC 29203-9264

COLUMBIA, SC 29204-2701

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:

120

185

80

120

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

Institutional Nursing Home:

0

0

0

0

OAKS OF BLYTHEWOOD INC

PRUITTHEALTH-COLIMBIA LLC

LUTHERAN HOMES OF SOUTH CAROLINA INC

WHITE OAK MANOR COLUMBIA 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

No

No

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

Alzheimer Unit:

No

No

No

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 46: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

46 hlfactcc.rdf

RichlandCounty:

Nursing HomeFacility Type:

WILDEWOOD DOWNS NURSING AND REHABILITATION CENTER

CHAVIS DIANA L PH#: 803-788-5115

80

731 POLO RD

Richland / Ltd. Liability

NCF-0914 / 12/31/2019

COLUMBIA, SC 29223-4462 FAC.#:803-788-5115

731 POLO RD

COLUMBIA, SC 29223-4462

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

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Beds: Nursing Home: 80 Institutional Nursing Home: 0

Number of Activities/Facilities licensed: 13 Number Licensed Units: 1,938

WILDEWOOD DOWNS RETIREMENT LLC

Totals For Facility/License Type: Nursing Home

Facility Email: [email protected]

Licensed

Units

Certifications:

Alzheimer Care:

None

NoAlzheimer Unit:No Max # Resident: Max # Beds:0 0

Page 47: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

47 hlfactcc.rdf

RichlandCounty:

PSAD InpatientFacility Type:

LEXINGTON/RICHLAND ALCOHOL & DRUG ABUSE/DETOX UNIT

MARTIN JEREMY D PH#:

16

2711 COLONIAL DR

Richland / Non-Profit Corporation

ITP-0009 / 05/31/2019

COLUMBIA, SC 29203-6818 FAC.#:803-726-9300

PO BOX 50597

COLUMBIA, SC 29250-0597

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: 16

Licensed Beds:Medical Detox: 16 Social Detox: 0 Res. Trestment Program: 0

LEXINGTON-RICHLAND ALCOHOL AND DRUG ABUSE COUNCIL INC

Totals For Facility/License Type: PSAD Inpatient

Facility Email: [email protected]

Licensed

Units

Page 48: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

48 hlfactcc.rdf

RichlandCounty:

PSAD OutpatientFacility Type:

ALTERNATIVES LIFE IMPROVEMENT CENTER-COLUMBIA

CROSSROADS TREATMENT CENTER OF COLUMBIA

FIFTH JUDICIAL CIRCUIT SOLICITOR'S OFFICE TREATMENT

PROGRAM

INSIGHTS EDUCATIONAL AND TREATMENT SERVICES

LEXINGTON RICHLAND CENTER FOR SUBSTANCE ABUSE &

BEHAVIORIAL PROGRAM

LEXINGTON-RICHLAND ALCOHOL AND DRUG ABUSE COUNCIL

SUDDETH JUSTIN PH#:

CROVELL EBONY PH#: 803-733-5855

BILTON WILLIAM PH#:

COLE RICHARD M PH#: 803-750-8444

MCFADDEN HENRY P PH#: 803-740-9298

MARTIN JEREMY D PH#:

1

1

1

2

1

2

1620 LADY ST UNIT B

1421 BLUFF RD

1716 MAIN ST

1441 SAINT ANDREWS RD

1105 BELLEVIEW ST STE 101

2711 COLONIAL DR

Richland / Corporation

Richland / Professional Corporation

Richland / County

Richland / Corporation

Richland / Sole Proprietorship

Richland / Non-Profit Corporation

OTP-0116 / 11/30/2019

OTPN-0109 / 03/31/2019

OTP-0122 / 07/31/2019

OTP-0011 / 07/31/2019

OTP-0097 / 06/30/2019

OTP-0012 / 07/31/2019

COLUMBIA, SC 29201-2967 FAC.#:803-252-4111

COLUMBIA, SC 29201-4809 FAC.#:803-733-5855

COLUMBIA, SC 29201 FAC.#:803-576-1893

COLUMBIA, SC 29210-5929 FAC.#:803-750-8444

COLUMBIA, SC 29201-1868 FAC.#:803-740-9298

COLUMBIA, SC 29203-6818 FAC.#:803-726-9300

1410 BLANDING ST STE 101

105 N SPRING ST STE 109

PO BOX 192

1441 SAINT ANDREWS RD

PO BOX 8724

PO BOX 50597

COLUMBIA, SC 29201-2967

GREENVILLE, SC 29601-2859

COLUMBIA, SC 29202-0192

COLUMBIA, SC 29210-5929

COLUMBIA, SC 29202-8724

COLUMBIA, SC 29250-0597

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

County/Ownership TypeMailing/Billing AddressLicensee

ALTERNATIVES LIFE IMPROVEMENT CENTER INC

CROSSROADS TREATMENT CENTER OF COLUMBIA PC

FIFTH JUDICIAL CIRCUIT SOLICITOR'S OFFICE TREATMENT PROGRAM

INSIGHTS EDUCATIONAL AND TREATMENT SERVICES INC

MCFADDEN HENRY P

LEXINGTON-RICHLAND ALCOHOL AND DRUG ABUSE COUNCIL INC

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

Certifications:

Certifications:

Certifications:

Certifications:

Certifications:

Certifications:

None

Narcotics Treatment Program, Methodone Treatment Program

None

None

None

None

Page 49: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

49 hlfactcc.rdf

RichlandCounty:

PSAD OutpatientFacility Type:

PALMETTO HEALTH ADDICTION RECOVERY CENTER

PH#:

1

720 GRACERN RD STE 120

Richland / Non-Profit Corporation

OTP-0096 / 09/30/2019

COLUMBIA, SC 29210 FAC.#:803-296-6829

720 GRACERN RD STE 120

COLUMBIA, SC 29210

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: 9

PALMETTO HEALTH

Totals For Facility/License Type: PSAD Outpatient

Facility Email: [email protected]

Licensed

Units

Certifications:None

Page 50: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

50 hlfactcc.rdf

RichlandCounty:

Renal DialysisFacility Type:

BROAD RIVER DIALYSIS CENTER

CENTRAL COLUMBIA KIDNEY CENTER

COLUMBIA NORTHEAST KIDNEY CENTER

DENTSVILLE KIDNEY CENTER

FRESENIUS MEDICAL CARE COLUMBIA

FRESENIUS MEDICAL CARE COLUMBIA HOME DIALYSIS

PHILLIPS RN ADRIENNE PH#:

GRANT TIA G PH#: 803-771-0518

KAISER SANDRA PH#: 803-865-0554

MYERS ALTHERA L PH#: 803-865-1068

BALABAN VIRGIL PH#: 803-779-7511

LIVINGSTON EBONY PH#: 803-799-1266

12

25

22

10

30

2

4460 BROAD RIVER RD

3511 MEDICAL DR

7499 PARKLANE RD STE 136

201 COLUMBIA MALL BLVD STE 141

2125 ADAMS GROVE RD

121 PARK CENTRAL DR STE 101

Richland / State

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

ERD-0092 / 12/31/2019

ERD-0116 / 11/30/2019

ERD-0159 / 07/31/2019

ERD-0214 / 10/31/2019

ERD-0016 / 02/28/2019

ERD-0190 / 05/31/2019

COLUMBIA, SC 29210-4047 FAC.#:803-772-5397

COLUMBIA, SC 29203-6504 FAC.#:803-771-0518

COLUMBIA, SC 29223-7650 FAC.#:803-865-0554

COLUMBIA, SC 29223-7536 FAC.#:803-865-1068

COLUMBIA, SC 29203-7102 FAC.#:803-779-7511

COLUMBIA, SC 29203-6476 FAC.#:803-799-1266

PO BOX 21787

3511 MEDICAL DR

7499 PARKLANE RD STE 136

201 COLUMBIA MALL BLVD STE 141

2125 ADAMS GRV

121 PARK CENTRAL DR STE 101

COLUMBIA, SC 29221-1787

COLUMBIA, SC 29203-6504

COLUMBIA, SC 29223-7650

COLUMBIA, SC 29223-7536

COLUMBIA, SC 29203-7102

COLUMBIA, SC 29203-6476

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

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

12

24

20

10

30

0

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

0

1

2

1

0

5

SC DEPT OF CORRECTIONS

CENTRAL COLUMBIA KIDNEY CENTER LLC

COLUMBIA NORTHEAST KIDNEY CENTER LLC

DENTSVILLE KIDNEY CENTER LLC

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS LLC

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS 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 51: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

51 hlfactcc.rdf

RichlandCounty:

Renal DialysisFacility Type:

FRESENIUS MEDICAL CARE IRMO

FRESENIUS MEDICAL CARE LOWER RICHLAND

FRESENIUS MEDICAL CARE MEADOWLAKE

FRESENIUS MEDICAL CARE MIDTOWN

FRESENIUS MEDICAL CARE NORTH STAR

FRESENIUS MEDICAL CARE SOUTH COLUMBIA

REMBERT LAWANDA PH#: 803-749-7088

JAMES LAVONNE PH#: 803-695-3628

LANCASTER JESSICA PH#: 803-754-7377

YOUNG RN DEQUATA M PH#: 803-771-0107

LEWIS TE'ERICA PH#:

CARTER SAMONTRA PH#: 803-779-4073

21

20

21

33

21

21

1012 LYKES LN

1840 PINEVIEW DR

7631 WILSON BLVD

150 PARK CENTRAL DR

140 HIGHLAND CENTER DR

2139 ADAMS GRV RD

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

ERD-0117 / 02/28/2019

ERD-0076 / 02/28/2019

ERD-0100 / 02/28/2019

ERD-0078 / 02/28/2019

ERD-0216 / 01/31/2020

ERD-129 / 02/28/2019

IRMO, SC 29063-8444 FAC.#:803-749-7088

COLUMBIA, SC 29209-5085 FAC.#:803-695-3628

COLUMBIA, SC 29203-3020 FAC.#:803-754-7377

COLUMBIA, SC 29203 FAC.#:803-799-6355

COLUMBIA, SC 29203-9247 FAC.#:803-736-0473

COLUMBIA, SC 29203-7102 FAC.#:803-779-4073

1012 LYKES LN

1840 PINEVIEW DR

7631 WILSON BLVD

150 PARK CENTRAL DR

140 HIGHLAND CENTER DR

2139 ADAMS GRV RD

IRMO, SC 29063-8444

COLUMBIA, SC 29209-5085

COLUMBIA, SC 29203-3020

COLUMBIA, SC 29203

COLUMBIA, SC 29203-9247

COLUMBIA, SC 29203-7102

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

County/Ownership TypeMailing/Billing AddressLicensee

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Licensed Stations:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

Hemodialysis:

21

20

21

30

21

21

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

Peritoneal:

0

0

0

3

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

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS LLC

FRESENIUS MEDICAL CARE CNA KIDNEY CENTERS 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 52: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

52 hlfactcc.rdf

RichlandCounty:

Renal DialysisFacility Type:

NORTH MAIN KIDNEY CENTER

POSTON RN PAMELA G PH#: 803-779-1201

23

3900 N MAIN ST STE A

Richland / Limited Liability

ERD-0192 / 10/31/2019

COLUMBIA, SC 29203-6471 FAC.#:803-779-1201

3900 N MAIN ST

COLUMBIA, SC 29203-6471

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 13 Number Licensed Units: 261

Licensed Stations: Hemodialysis: 21 Peritoneal: 2

NORTH MAIN KIDNEY CENTER LLC

Totals For Facility/License Type: Renal Dialysis

Facility Email: [email protected]

Licensed

Units

Page 53: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

53 hlfactcc.rdf

RichlandCounty:

Tattoo FacilityFacility Type:

3 ACES TATTOO

36 SOUTH TATTOO

737 GRAPHIC INK STUDIO

ANIMATED CANVAS CUSTOM TATTOO

BORN AGAIN TATTOO

COPPER FINCH TATTOO-NORTHEAST

DARK HORSE TATTOO

DEVINE STREET TATTOO

PH#:

PH#:

PH#:

ANIMATED CANVAS LLC PH#: 803-758-6002

HOLLEY-PATEL JOYA PH#:

ROBERTS EDDIE E PH#:

HAGEN FAY WILLARD PH#: 803-386-4097

CHESTON JONATHAN E PH#: 843-641-7250

4

5

2

4

3

5

6

5

8502 TWO NOTCH RD STE G

4051 BROAD RIVER RD STE B

113 BARTON CREEK CT STE C

1209 PARK ST

2002 GREENE ST UNIT D

10203 TWO NOTCH RD STE D

4422 DEVINE ST

4441 DEVINE ST

Richland /

Richland / Limited Liability

Richland /

Richland / Sole Proprietorship

Richland /

Richland / Limited Liability Company (single member)

Richland / Limited Liability

Richland / Partnership

TF-0305 / 03/31/2019

TF-0317 / 10/31/2019

TF-0295 / 12/31/2018 (Renewal Pending)

TF-0052 / 08/31/2019

TF-0275 / 10/31/2019

TF-0180 / 02/28/2019

TF-0133 / 12/31/2019

TF-0074 / 10/31/2019

COLUMBIA, SC 29223 FAC.#:803-764-4472

COLUMBIA, SC 29210-4003 FAC.#:803-569-6181

COLUMBIA, SC 29229 FAC.#:619-274-0850

COLUMBIA, SC 29201-3139 FAC.#:803-758-6002

COLUMBIA, SC 29205 FAC.#:803-636-1627

COLUMBIA, SC 29229 FAC.#:803-354-7700

COLUMBIA, SC 29205-3612 FAC.#:803-708-2942

COLUMBIA, SC 29205-3611 FAC.#:803-782-0753

8502 TWO NOTCH RD STE G

113 BARTON CREEK CT STE C

1209 PARK ST

2002 GREENE ST UNIT D

10203 TWO NOTCH RD STE D

PO BOX 32404

COLUMBIA, SC 29223

COLUMBIA, SC 29229

COLUMBIA, SC 29201-3139

COLUMBIA, SC 29205

COLUMBIA, SC 29229

CHARLESTON, SC 29417-2404

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

County/Ownership TypeMailing/Billing AddressLicensee

3 ACES TATTOO LLC

COPPER FINCH TATTOO CO LLC

737 GRAPHIC INK STUDIO LLC

ANIMATED CANVAS LLC

PATEL TATTOOS LLC

COPPER FINCH TATTOO LLC

VIKING VISIONARIES LLC

DEVINE STREET TATTOO 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]

COPPERFINCHTATTOO.YAHOO.COM

[email protected]

[email protected]

Licensed

Units

Page 54: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

54 hlfactcc.rdf

RichlandCounty:

Tattoo FacilityFacility Type:

DIAMOND CUT TATTOO COMPANY

INDIGO ROSE TATTOO STUDIO

KNOTTY HEADZ TATTOO FACTORY

MAGNETIZM TATTOO

MAGNETIZM TATTOO NORTH

OUCH! TATTOOS

SICKLE AND MOON TATTOO

TATTOO TRILLIONAIRES

JENKINS JARRETT MCCOY PH#: 803-364-2241

PURVIS SHANNON PH#: 803-799-2844

RORIE WOODROW D PH#: 803-212-8349

COKLEY JAMES PH#: 803-419-4700

PH#:

GARENS ELIZABETH PH#: 803-397-8284

LEWIS JEREMY L PH#: 803-546-9957

DAVIS III WILLIE J PH#: 803-600-4973

4

3

3

5

3

2

5

5

4451 DEVINE ST

2009 GREENE ST STE 112

1608 DECKER BLVD STE A

7345 PARKLANE RD STE C

3506 N MAIN ST

10240 TWO NOTCH RD STE 4

2009 GREENE ST STE 106

7352 TWO NOTCH RD STE A

Richland / Sole Proprietorship

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

Richland / Limited Liability

TF-0169 / 08/31/2019

TF-0026 / 01/31/2019

TF-0040 / 05/31/2019

TF-0075 / 08/31/2019

TF-0320 / 08/31/2019

TF-0091 / 05/31/2019

TF-0167 / 04/30/2019

TF-0108 / 08/31/2019

COLUMBIA, SC 29205-3611 FAC.#:803-497-3980

COLUMBIA, SC 29205-1683 FAC.#:803-799-2844

COLUMBIA, SC 29206-5246 FAC.#:803-790-7029

COLUMBIA, SC 29223-7698 FAC.#:803-419-4700

COLUMBIA, SC 29203 FAC.#:803-722-4972

COLUMBIA, SC 29229-4217 FAC.#:803-397-8284

COLUMBIA, SC 29205-1683 FAC.#:803-546-9957

COLUMBIA, SC 29223-7620 FAC.#:803-699-0114

4451 DEVINE ST

2009 GREENE ST STE 112

1608 DECKER BLVD STE A

2155 LAKE CAROLINA DR

10240 TWO NOTCH RD STE 4

2009 GREENE ST STE 106

7352 TWO NOTCH RD STE A

COLUMBIA, SC 29205-3611

COLUMBIA, SC 29205-1683

COLUMBIA, SC 29206-5246

COLUMBIA, SC 29229

COLUMBIA, SC 29229-4217

COLUMBIA, SC 29205-1683

COLUMBIA, SC 29223-7620

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

County/Ownership TypeMailing/Billing AddressLicensee

PAGE EMANUEL B

INDIGO ROSE TATTOO STUDIO INC

KNOTTY HEADZ TATTOO FACTORY LLC

MAGNETIZM TATTOO LLC

MAGNETIZM TATTOO LLC

OUCH! LLC

SICKLE AND MOON TATTOO LLC

DAVIS & SON ENTERPRISES 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 55: January 9, 2019 South Carolina Department of Health ... · BLYTHEWOOD, SC 29016-7221 COLUMBIA, SC 29229 COLUMBIA, SC 29223 Facility Name Location Street Location City, State Administrator/Phone

South Carolina Department of Health & Environmental Control

Division of Health Licensing

January 9, 2019

55 hlfactcc.rdf

RichlandCounty:

Tattoo FacilityFacility Type:

VISION QUEST BODY ART & GALLERY

PHIPPS MICHAEL STEVEN PH#: 803-606-5826

3

2620 MAIN ST

Richland / Sole Proprietorship

TF-0172 / 09/30/2019

COLUMBIA, SC 29201-1726 FAC.#:803-542-7115

2620 MAIN ST

COLUMBIA, SC 29203

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

County/Ownership TypeMailing/Billing AddressLicensee

Number of Activities/Facilities licensed: 17 Number Licensed Units: 67

Number of Activities/Facilities licensed in county of :

Number Licensed Units : 7,386

VISION QUEST BODY ART & GALLERY LLC

Totals For Facility/License Type: Tattoo Facility

Total Number of Activities/Facilities licensed: 244 Total Number Licensed Units: 7,386

Report Totals

Richland 244# Lics:

Facility Email: [email protected]

Licensed

Units