January 9, 2019 South Carolina Department of Health ... · SPARTANBURG, SC 29306-4807...
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South Carolina Department of Health & Environmental Control Division of Health Licensing January 9, 2019 1 hlfactcc.rdf Spartanburg County: Adult Day Care Facility Type: ACTIVE DAY OF BOILING SPRINGS ELITE SENIOR DAY CENTER OF SPARTANBURG STROUD LYNN PH#: PH#: 60 60 230 GILES DR 2000 BUD ARTHUR BRIDGE RD Spartanburg / Corporation Spartanburg / Limited Liability ADC-0413 / 11/30/2019 ADC-0406 / 05/31/2019 BOILING SPRINGS, SC 29316-6036 FAC.#:864-599-7342 SPARTANBURG, SC 29307-4417 FAC.#:864-642-1916 2000 BUD ARTHUR BRIDGE RD SPARTANBURG, SC 29307-4417 Facility Name Location Street Location City, State Administrator/Phone License Nbr/Expiration Date County/Ownership Type Mailing/Billing Address Licensee Number of Participants: Number of Participants: 60 60 Number of Activities/Facilities licensed: 2 Number Licensed Units: 120 ACTIVE SC ONE INC ELITE HOMECARE Totals For Facility/License Type: Adult Day Care Facility Email: Facility Email: [email protected] [email protected] Licensed Units
Transcript of January 9, 2019 South Carolina Department of Health ... · SPARTANBURG, SC 29306-4807...
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
1 hlfactcc.rdf
SpartanburgCounty:
Adult Day CareFacility Type:
ACTIVE DAY OF BOILING SPRINGS
ELITE SENIOR DAY CENTER OF SPARTANBURG
STROUD LYNN PH#:
PH#:
60
60
230 GILES DR
2000 BUD ARTHUR BRIDGE RD
Spartanburg / Corporation
Spartanburg / Limited Liability
ADC-0413 / 11/30/2019
ADC-0406 / 05/31/2019
BOILING SPRINGS, SC 29316-6036 FAC.#:864-599-7342
SPARTANBURG, SC 29307-4417 FAC.#:864-642-1916
2000 BUD ARTHUR BRIDGE RD
SPARTANBURG, SC 29307-4417
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Participants:
Number of Participants:
60
60
Number of Activities/Facilities licensed: 2 Number Licensed Units: 120
ACTIVE SC ONE INC
ELITE HOMECARE
Totals For Facility/License Type: Adult Day Care
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
2 hlfactcc.rdf
SpartanburgCounty:
Ambulatory SurgeryFacility Type:
AMBULATORY SURGERY CENTER OF SPARTANBURG
GHS SURGERY CENTER - SPARTANBURG
SPARTANBURG SURGERY CENTER
SURGERY CENTER AT PELHAM
JENNINGS MARY JANE PH#: 864-504-3555
ARMS DEBBIE PH#: 864-587-5768
SIZEMORE RICK PH#: 864-585-2002
HAZEN BILL PH#: 864-334-2400
9
2
6
6
720 N PINE ST
1413 JOHN B WHITE SR BLVD STE D
391 SERPENTINE DR STE 200
2755 S HWY 14
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Ltd. Liability
ASF-0064 / 04/30/2019
ASF-0134 / 10/31/2019
ASF-0139 / 04/30/2019
ASF-0091 / 12/31/2019
SPARTANBURG, SC 29303-3127 FAC.#:864-504-3555
SPARTANBURG, SC 29306-3995 FAC.#:864-797-8791
SPARTANBURG, SC 29303-3079 FAC.#:864-585-2002
GREER, SC 29650-4902 FAC.#:864-334-2400
720 N PINE ST
1413 JOHN B WHITE SR BLVD STE D
2755 S HWY 14
SPARTANBURG, SC 29303-3127
SPARTANBURG, SC 29306-3995
GREER, SC 29650-4902
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Operating Rooms:
Operating Rooms:
Operating Rooms:
Operating Rooms:
7
2
4
4
Procedure Rooms:
Procedure Rooms:
Procedure Rooms:
Procedure Rooms:
0
0
2
0
Endoscopy Rooms:
Endoscopy Rooms:
Endoscopy Rooms:
Endoscopy Rooms:
2
0
0
2
Number of Activities/Facilities licensed: 4 Number Licensed Units: 23
AMBULATORY SURGERY CENTER OF SPARTANBURG LLC
UPSTATE AFFILIATE ORGANIZATION
SPARTANBURG SURGERY CENTER LLC
SURGERY CENTER AT PELHAM LLC
Totals For Facility/License Type: Ambulatory Surgery
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
3 hlfactcc.rdf
SpartanburgCounty:
Birthing CenterFacility Type:
LABORS OF LOVE BIRTH CENTER
WEAVER LINDA K PH#: 864-285-0574
2
850 FLOYD RD EXT
Spartanburg / Limited Liability
BC-0008 / 03/31/2019
SPARTANBURG, SC 29307-1048 FAC.#:864-285-0574
850 FLOYD RD EXT
SPARTANBURG, SC 29307-1048
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: 2
LABORS OF LOVE BIRTH CENTER LLC
Totals For Facility/License Type: Birthing Center
Facility Email: [email protected]
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
4 hlfactcc.rdf
SpartanburgCounty:
Body PiercingFacility Type:
MADHOUSE PIERCING & MORE
STICKS AND STONES
VOODOO PIERCING
SMITH PERRY D PH#: 864-381-0555
LAYTON AMANDA PH#: 864-804-6440
PH#:
1
1
1
3425 BOILING SPRINGS RD
8009 WARREN H ABERNATHY HWY
3446 B BOILING SPRINGS RD
Spartanburg / Sole Proprietorship
Spartanburg / Corporation
Spartanburg / Sole Proprietorship
BP-0225 / 03/31/2019
BP-0212 / 09/30/2019
BP-0283 / 11/30/2018 (Renewal Pending)
BOILING SPRINGS, SC 29316-6019 FAC.#:864-909-9822
SPARTANBURG, SC 29301-2449 FAC.#:864-804-6440
BOILING SPRINGS, SC 29316 FAC.#:864-707-5543
3425 BOILING SPRINGS RD
8009 WARREN H ABERNATHY HWY
3446 B BOLING SPRINGS RD
BOILING SPRINGS, SC 29316-6019
SPARTANBURG, SC 29301-2449
BOILING SPRINGS, SC 29316
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Activities/Facilities licensed: 3 Number Licensed Units: 3
SMITH PERRY D
ALAYA INC
HOLDEN KERISE PAYNE
Totals For Facility/License Type: Body Piercing
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
5 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
ASHLAN VILLAGE
BENCHMARK HOMES - SPARTANBURG
CANTRELL'S RESIDENTIAL CARE FACILITY
EDEN TERRACE OF SPARTANBURG
INVERNESS AT SPARTANBURG
AHO ROBERT M PH#: 864-949-7825
MASON SUZAN B PH#: 864-562-2470
WALKER LINDA C PH#: 864-587-1993
HUGHES CINDY B PH#: 864-579-7387
GROTE EMILY K PH#: 864-591-1116
72
12
22
140
100
415 BRENDA WAY
450 W HENRY ST
124 GLADYS CT
2780 E MAIN ST
2720 COUNTRY CLUB RD
Spartanburg / Limited Liability
Spartanburg / State
Spartanburg / Corporation
Spartanburg / Ltd. Liability
Spartanburg / Limited Liability
CRC-1483 / 10/31/2019
CRC-1509 / 09/30/2019
CRC-1105 / 06/30/2019
CRC-1213 / 05/31/2019
CRC-1351 / 07/31/2019
LYMAN, SC 29365-9264 FAC.#:864-949-7825
SPARTANBURG, SC 29306-6037 FAC.#:864-562-2470
SPARTANBURG, SC 29301-3701 FAC.#:864-587-1993
SPARTANBURG, SC 29307-1248 FAC.#:864-579-7387
SPARTANBURG, SC 29302-4473 FAC.#:864-591-1116
415 BRENDA WAY
195 BURDETTE ST
124 GLADYS CT
2780 E MAIN ST
PO BOX 2568
LYMAN, SC 29365-9264
SPARTANBURG, SC 29307-1003
SPARTANBURG, SC 29301-3701
SPARTANBURG, SC 29307
HICKORY, NC 28603-2568
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
ASHLAN PROPERTIES LLC
CHARLES LEA CENTER
CANTRELL'S RESIDENTIAL CARE FACILITY INC
BRISTOL SPARTANBURG LLC
DSJ AL HOLDINGS LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Certifications:
Certifications:
Certifications:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
None
None
None
None
None
Yes
No
No
Yes
Yes
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Yes
No
No
Yes
Yes
Max # Resident:
Max # Resident:
Max # Resident:
Max # Resident:
Max # Resident:
Max # Beds:
Max # Beds:
Max # Beds:
Max # Beds:
Max # Beds:
19
0
0
29
16
20
0
0
48
20
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
6 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
LAKEWOOD SENIOR LIVING
LANDRUM COMMUNITY RESIDENCE I
LANDRUM COMMUNITY RESIDENCE II
MIDWAY RESIDENTIAL CARE FACILITY #1
MIDWAY RESIDENTIAL CARE FACILITY #1A
BOWMAN KAREN S PH#: 864-586-1457
MASON SUZAN B PH#: 864-457-1374
MASON SUZAN B PH#: 864-457-1374
WALKER LINDA C PH#: 864-433-8999
WALKER LINDA C PH#: 864-433-8999
90
5
5
13
14
3709 CLARK RD
722 BOMAR AVE
722 BOMAR AVE
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
Spartanburg / Limited Liability
Spartanburg / State
Spartanburg / State
Spartanburg / Corporation
Spartanburg / Corporation
CRC-1924 / 10/31/2019
CRC-1507 / 08/31/2019
CRC-1508 / 08/31/2019
CRC-0318 / 12/31/2019
CRC-0320 / 12/31/2019
BOILING SPRINGS, SC 29316 FAC.#:864-586-1457
LANDRUM, SC 29356 FAC.#:864-457-1370
LANDRUM, SC 29356 FAC.#:864-457-1374
MOORE, SC 29369-9721 FAC.#:864-433-8999
MOORE, SC 29369-9721 FAC.#:864-433-8999
PO BOX 6384
195 BURDETTE ST
195 BURDETTE ST
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
SPARTANBURG, SC 29304-6384
SPARTANBURG, SC 29307-1003
SPARTANBURG, SC 29307-1003
MOORE, SC 29369-9721
MOORE, SC 29369-9721
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
CR LAKEWOOD LLC
CHARLES LEA CENTER
CHARLES LEA CENTER
MIDWAY RESIDENTIAL CARE FACILITY INC
MIDWAY RESIDENTIAL CARE FACILITY INC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Certifications:
Certifications:
Certifications:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
None
None
None
None
None
Yes
No
No
No
No
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Yes
No
No
No
No
Max # Resident:
Max # Resident:
Max # Resident:
Max # Resident:
Max # Resident:
Max # Beds:
Max # Beds:
Max # Beds:
Max # Beds:
Max # Beds:
0
0
0
0
0
20
0
0
0
0
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
7 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
MIDWAY RESIDENTIAL CARE FACILITY #2
MIDWAY RESIDENTIAL CARE FACILITY #3
MIDWAY RESIDENTIAL CARE FACILITY #4
MIDWAY RESIDENTIAL CARE FACILITY #5
MILLER'S PLACE
WALKER LINDA C PH#: 864-433-8999
WALKER LINDA C PH#: 864-433-8999
WALKER LINDA C PH#: 864-433-8999
WALKER LINDA C PH#: 864-433-8999
MILLER ANNIE M PH#: 864-573-7008
25
17
14
12
19
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
140 COX ST
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / Limited Liability
CRC-0321 / 12/31/2019
CRC-0346 / 12/31/2019
CRC-0322 / 12/31/2019
CRC-0616 / 12/31/2019
CRC-0897 / 11/30/2019
MOORE, SC 29369-9721 FAC.#:864-433-8999
MOORE, SC 29369-9721 FAC.#:864-433-8999
MOORE, SC 29369-9721 FAC.#:864-433-8999
MOORE, SC 29369-9721 FAC.#:864-433-8999
SPARTANBURG, SC 29306-4807 FAC.#:864-573-7008
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
4026 MOORE DUNCAN HWY
226 NASH RD
MOORE, SC 29369-9721
MOORE, SC 29369-9721
MOORE, SC 29369-9721
MOORE, SC 29369-9721
MOORE, SC 29369-9695
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
MIDWAY RESIDENTIAL CARE FACILITY INC
MIDWAY RESIDENTIAL CARE FACILITY INC
MIDWAY RESIDENTIAL CARE FACILITY INC
MIDWAY RESIDENTIAL CARE FACILITY INC
MILLER PLACE LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
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
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
8 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
MONTROSE MANOR
OAKRIDGE COMMUNITY CARE HOME #1
OAKRIDGE COMMUNITY CARE HOME #2
PACIFICA SENIOR LIVING SKYLYN
REID HOUSE INC
DEL-TORO MARIANNA PH#: 864-476-9100
MAST DARRYL PH#: 864-472-6979
COKER ROBIN S PH#: 864-708-3299
KENNEDY SHERRY S PH#: 864-582-6838
DANIELS KEISHA G PH#: 864-949-5120
60
38
10
169
42
80 MEDICAL CENTER DR
2470 OLD MILL RD
35 S HOWARD ST
1705 SKYLN DR
117 DODD ST
Spartanburg /
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Corporation
CRC-1417 / 12/31/2018 (Renewal Pending)
CRC-0241 / 08/31/2019
CRC-0429 / 04/30/2019
CRC-1950 / 12/31/2019
CRC-1463 / 03/31/2019
WOODRUFF, SC 29388-8781 FAC.#:864-476-9100
INMAN, SC 29349-9276 FAC.#:864-472-6979
INMAN, SC 29349-1339 FAC.#:864-708-3299
SPARTANBURG, SC 29307 FAC.#:864-582-6838
WELLFORD, SC 29385-9475 FAC.#:864-949-5120
80 MEDEICAL CENTER DR
2470 OLD MILL RD
35 S HOWARD ST
1775 HANCOCK ST STE 200
117 DODD ST
WOODRUFF, SC 29388-8781
INMAN, SC 29349-9276
INMAN, SC 29349-1339
SAN DIEGO, CA 92110
WELLFORD, SC 29385-9475
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
LAKEFIELD PROPERTIES LLC
OAKRIDGE COMMUNITY CARE HOME INC
OAKRIDGE COMMUNITY CARE HOME INC
PACIFICA SKYLYN LLC
REID HOUSE INC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
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
Yes
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
20
0
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
9 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
REID'S RESIDENTIAL CARE FACILITY
ROSECREST COMMUNITY RESIDENTIAL CARE
ROSEWOOD ASSISTED LIVING
SUMMIT HILLS ASSISTED LIVING COMMUNITY
WATERFORD AT DILLION POINTE ASSISTED LIVING & MEMORY
CARE
DANIELS JUDY C PH#: 864-439-9238
YETTER MELISSA PH#: 864-599-8600
CLOBES KIMBERLY H PH#: 864-573-4060
BECTON JOSHUA PH#: 864-591-2222
COLEMAN ALLYE PH#: 864-948-9300
23
45
67
79
55
726 OLD SPARTANBURG HWY
200 FORTRESS DR
5221 HWY 215
100 SUMMIT HILLS DR
104 DILLON DR
Spartanburg / Sole Proprietorship
Spartanburg / Non-Profit Corporation
Spartanburg / Ltd. Liability
Spartanburg / Ltd. Liability
Spartanburg /
CRC-0771 / 05/31/2019
CRC-1208 / 07/31/2019
CRC-1367 / 11/30/2018 (Renewal Pending)
CRC-1113 / 09/30/2019
CRC-0893 / 06/30/2019
WELLFORD, SC 29385-9668 FAC.#:864-439-9238
INMAN, SC 29349-9160 FAC.#:864-599-8600
PAULINE, SC 29374-1908 FAC.#:864-573-4060
SPARTANBURG, SC 29307-1532 FAC.#:864-591-2222
SPARTANBURG, SC 29307-1018 FAC.#:864-948-9300
726 OLD SPARTANBURG HWY
200 FORTRESS DR
PO BOX 35
3530 TORINGDON WAY STE 204
104 DILLON DR
WELLFORD, SC 29385-9668
INMAN, SC 29349-9160
PAULINE, SC 29374-0035
CHARLOTTE, NC 28277-3436
SPARTANBURG, SC 29307-1018
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
JUDY DANIELS
LUTHERAN HOMES OF SOUTH CAROLINA INC
ROSEWOOD ASSISTED LIVING LLC
SUMMIT HILLS LLC
CSL DILLION POINTE SC LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
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
Yes
Yes
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
No
Yes
No
Yes
Yes
Max # Resident:
Max # Resident:
Max # Resident:
Max # Resident:
Max # Resident:
Max # Beds:
Max # Beds:
Max # Beds:
Max # Beds:
Max # Beds:
0
11
0
23
27
0
11
0
13
22
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
10 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
WESLEY COURT ASSISTED LIVING COMMUNITY
WHITE OAK ESTATES ASSISTED LIVING
WOODBRIDGE SENIOR LIVING
WOODLAND PLACE
WRIGHT'S RESIDENTIAL CARE #2 A & B
TURNAGE HEATHER R PH#: 864-599-9929
FOWLER JENNIFER M PH#: 864-579-7004
BOUDREAU GAIL PH#: 864-579-0086
PH#:
WRIGHT DIANNE E PH#: 864-949-6437
70
45
73
108
10
916 WESLEY CT
400 WEBBER RD
2902 E MAIN ST
850 JOHN B WHITE BLVD
12 RIVER ST, 12A & 12B
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Sole Proprietorship
CRC-1289 / 12/31/2018 (Renewal Pending)
CRC-1334 / 09/30/2019
CRC-1991 / 10/31/2019
CRC-2038 / 08/31/2019
CRC-1319 / 07/31/2019
BOILING SPRINGS, SC 29316-5649 FAC.#:864-599-9929
SPARTANBURG, SC 29307-2400 FAC.#:864-579-7004
SPARTANBURG, SC 29307-1252 FAC.#:864-579-0086
SPARTANBURG, SC 29306 FAC.#:864-576-8190
LYMAN, SC 29365-1714 FAC.#:864-249-0412
916 WESLEY CT
400 WEBBER RD
2902 E MAIN ST
PO BOX 6384
950 OLD SPARTANBURG HWY
BOILING SPRINGS, SC 29316-5649
SPARTANBURG, SC 29307-2400
SPARTANBURG, SC 29307-1252
SPARTANBURG, SC 29304-6384
WELLFORD, SC 29385
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
WESLEY COURT ASSISTED LIVING FACILITY LLC
WHITE OAK ESTATES ASSISTED LIVING INC
CR WOODBRIDGE LLC
MI WOODLAND PLACE LLC
DIANNE E WRIGHT
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Certifications:
Certifications:
Certifications:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
None
None
None
None
None
No
No
Yes
Yes
No
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
No
Yes
Yes
Yes
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
45
0
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
11 hlfactcc.rdf
SpartanburgCounty:
Community Residential Care FacilityFacility Type:
WRIGHT'S RESIDENTIAL CARE FACILITY 1
WRIGHT DIANNE E PH#: 864-249-0412
10
950 OLD SPARTANBURG HWY
Spartanburg / Sole Proprietorship
CRC-0617 / 01/31/2019
WELLFORD, SC 29385 FAC.#:864-249-0412
PO BOX 268
WELLFORD, SC 29385-0268
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Activities/Facilities licensed: 31 Number Licensed Units: 1,464
DIANNE E WRIGHT
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
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
12 hlfactcc.rdf
SpartanburgCounty:
Habilitation R15Facility Type:
BENCHMARK HOMES-COWPENS
FERGUSON DONATA PH#: 864-585-0322
12
204 GOFORTH ST
Spartanburg / State
MR15-0182 / 06/30/2019
COWPENS, SC 29330-9277 FAC.#:864-585-0322
PO BOX 4706, DDSN C/O RUFUS BRITT
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: 12
SC DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS
Totals For Facility/License Type: Habilitation R15
Facility Email: [email protected]
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
13 hlfactcc.rdf
SpartanburgCounty:
Home HealthFacility Type:
BIOSCRIP INFUSION SERVICES
SPARTANBURG MEDICAL CENTER HOME HEALTH
NEAL TONI R PH#: 864-583-8190
ANDERSON DAVID PH#:
9
4
160 CONGRESS BLVD STE D
120 HEYWOOD AVE STE 300
Spartanburg / Corporation
Spartanburg / District
HHA-0211 / 11/30/2019
HHA-0038 / 09/30/2019
DUNCAN, SC 29334-8890 FAC.#:864-583-8190
SPARTANBURG, SC 29302-1211 FAC.#:864-560-3900
1600 BROADWAY STE 700
120 HEYWOOD AVE STE 300
DENVER, CO 80202
SPARTANBURG, SC 29302-1211
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: 13
HOMECHOICE PARTNERS INC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Counties Served:
Counties Served:
Anderson, Cherokee, Greenville, Laurens, Oconee, Pickens, Spartanburg, Union, York
Cherokee, Greenville, Spartanburg, Union
Totals For Facility/License Type: Home Health
License Restrictions:
License Restrictions:
Physical Therapy:
Physical Therapy:
N
Y
Speech Therapy:
Speech Therapy:
N
Y
Occupational Therapy:
Occupational Therapy:
N
Y
Med. Social Services:
Med. Social Services:
N
Y
Home Health Aid:
Home Health Aid:
N
Y
Medical Supplies/Appliances/Durable Medical Equipment:
Medical Supplies/Appliances/Durable Medical Equipment:
N
N
Other:
Other:
SKILLED NURSING
SKILLED NURSING
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
14 hlfactcc.rdf
SpartanburgCounty:
Hospice FacilityFacility Type:
HOSPICE HOUSE OF THE CAROLINA FOOTHILLS
SPARTANBURG REGIONAL HOSPICE HOME
BURCH RITA R PH#: 828-245-0095
ROSS KIMBERLY G PH#: 864-560-5620
12
15
260 FAIRWINDS RD
686 JEFF DAVIS DR
Spartanburg / Corporation
Spartanburg / District
HPF-0027 / 03/31/2019
HPF-0007 / 12/31/2019
LANDRUM, SC 29356-9075 FAC.#:864-457-9100
SPARTANBURG, SC 29303-2092 FAC.#:864-560-5620
PO BOX 336
686 JEFF DAVIS DR
FOREST CITY, NC 28043-0336
SPARTANBURG, SC 29303-2092
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: 27
HOSPICE OF RUTHERFORD COUNTY INC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Totals For Facility/License Type: Hospice Facility
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
15 hlfactcc.rdf
SpartanburgCounty:
Hospice ProgramFacility Type:
HOSPICE CARE OF SOUTH CAROLINA
HOSPICE COMPASSUS GREENVILLE/SPARTANBURG
HOSPICE OF THE CAROLINA FOOTHILLS
KINDRED HOSPICE
SPARTANBURG REGIONAL MEDICAL CENTER HOSPICE
POWELL DAVID M PH#:
RIDDLESPURGER EDITH S PH#: 864-542-2536
BURCH RITA R PH#: 828-245-0095
KEATON SHAMILA N PH#:
ROSS KIMBERLY G PH#: 864-560-5620
46
21
3
27
4
110 DILLON DR
1923 E MAIN ST STE B
260 FAIRWINDS RD
905 E MAIN ST STE 2
1530 DRAYTON RD
Spartanburg / Ltd. Liability
Spartanburg / Ltd. Liability
Spartanburg / Non-Profit Corporation
Spartanburg / Ltd. Liability
Spartanburg / District
HPC-0051 / 08/31/2019
HPC-0108 / 05/31/2019
HPC-0035 / 01/31/2019
HPC-0103 / 02/28/2019
HPC-0003 / 09/30/2019
SPARTANBURG, SC 29307-1018 FAC.#:864-542-2100
DUNCAN, SC 29334-8885 FAC.#:864-542-2536
LANDRUM, SC 29356-9075 FAC.#:828-457-9100
SPARTANBURG, SC 29302-2182 FAC.#:864-585-6500
DRAYTON, SC 29333-0430 FAC.#:864-560-3145
110 DILLON DR
1923 E MAIN ST STE B
260 FAIRWINDS RD
12900 FOSTER ST STE 400
PO BOX 430
SPARTANBURG, SC 29307-1018
DUNCAN, SC 29334-8885
LANDRUM, SC 29356-9075
OVERLAND PARK, KS 66213-2696
DRAYTON, SC 29333-0430
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
HOSPICE CARE OF SOUTH CAROLINA LLC
THI OF SOUTH CAROLINA HOSPICE LLC
HOSPICE OF RUTHERFORD COUNTY INC
WIREGRASS HOSPICE OF SOUTH CAROLINA LLC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
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, Anderson, Cherokee, Chester, Fairfield, Greenville, Greenwood, Kershaw,
Lancaster, Laurens, Lexington, McCormick, Newberry, Oconee, Pickens, Richland,
Saluda, Spartanburg, Sumter, Union, York
Cherokee, Greenville, Spartanburg
Aiken, Anderson, Barnwell, Calhoun, Cherokee, Chester, Darlington, Edgefield,
Fairfield, Florence, Greenville, Greenwood, Kershaw, Lancaster, Laurens, Lee,
Lexington, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg,
Sumter, Union, York
Cherokee, Greenville, Spartanburg, Union
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
16 hlfactcc.rdf
SpartanburgCounty:
Hospice ProgramFacility Type:
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: 101
Totals For Facility/License Type: Hospice Program
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
17 hlfactcc.rdf
SpartanburgCounty:
Hospital or Institutional General InfirmaryFacility Type:
CHILDREN'S HABILITATION CENTER
MARY BLACK HEALTH SYSTEM - SPARTANBURG
PELHAM MEDICAL CENTER
SPARTANBURG HOSPITAL FOR RESTORATIVE CARE
MADISON JOLENE PH#: 864-577-7803
PH#:
KOUSKOLEKAS ANTHONY T PH#: 864-530-2366
BUTLER ANITA M PH#: 864-560-3263
3
207
48
97
355 CEDAR SPRINGS RD
1700 SKYLYN DR
250 WESTMORELAND RD
389 SERPENTINE DR
Spartanburg / State
Spartanburg / Ltd. Liability
Spartanburg / District
Spartanburg / District
HTL-0449 / 06/30/2019
HTL-0704 / 07/31/2019
HTL-0905 / 09/30/2019
HTL-0685 / 08/31/2019
SPARTANBURG, SC 29302-4699 FAC.#:864-577-7803
SPARTANBURG, SC 29307-1061 FAC.#:864-573-3034
GREER, SC 29651-9013 FAC.#:864-530-2366
SPARTANBURG, SC 29303-3074 FAC.#:864-560-3263
PO BOX 3217
250 WESTMORELAND RD
389 SERPENTINE DR
SPARTANBURG, SC 29304-3217
GREER, SC 29651-9013
SPARTANBURG, SC 29303-3074
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:
3
174
48
97
Psychiatric:
Psychiatric:
Psychiatric:
Psychiatric:
0
15
0
0
Rehab:
Rehab:
Rehab:
Rehab:
0
18
0
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
10
0
0
SC SCHOOL FOR THE DEAF AND THE BLIND
MARY BLACK HEALTH SYSTEM LLC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Certifications:
Certifications:
None
Perinatal Level II, JCAHO Accredited
Abortions
None
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
18 hlfactcc.rdf
SpartanburgCounty:
Hospital or Institutional General InfirmaryFacility Type:
SPARTANBURG MEDICAL CENTER
SPARTANBURG REHABILITATION INSTITUTE
FEISAL JAMES P PH#: 864-560-6000
SCHULZ RICHARD W PH#: 864-594-9600
540
40
101 E WOOD ST
160 HAROLD FLEMING CT
Spartanburg / District
Spartanburg / Corporation
HTL-0125 / 03/31/2019
HTL-0911 / 08/30/2019
SPARTANBURG, SC 29303-3072 FAC.#:864-560-6000
SPARTANBURG, SC 29303-4226 FAC.#:864-594-9600
101 E WOOD ST
160 HAROLD FLEMING CT
SPARTANBURG, SC 29303-3072
SPARTANBURG, SC 29303-4226
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Licensed Beds:
Licensed Beds:
General:
General:
484
0
Psychiatric:
Psychiatric:
56
0
Rehab:
Rehab:
0
40
Substance Abuse:
Substance Abuse:
0
0
Other Beds :
Other Beds :
NICU:
NICU:
13
0
Neonatal Special Care:
Neonatal Special Care:
22
0
Number of Activities/Facilities licensed: 6 Number Licensed Units: 935
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
SPARTANBURG REHABILITATION INSTITUTE INC
Totals For Facility/License Type: Hospital or Institutional General Infirmary
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Trauma Center Level I, Perinatal Level III Regional
JCAHO Accredited
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
19 hlfactcc.rdf
SpartanburgCounty:
Inhome Care ProviderFacility Type:
A REMEDY HOME CARE
AEROFLOW INC
ALL ABOUT CARE
ALL GENERATIONS HOME CARE
AXCESS HEALTHCARE SERVICES LLC
CHARLES LEA CENTER
CIRCLE OF ANGELS HEALTH CARE
COMFORT KEEPERS SPARTANBURG
PH#:
BEAUCHAMP AUDRA M PH#: 888-345-1780
PH#:
PH#:
PH#:
BERNARD GERALD PH#: 864-585-0322
PH#:
PH#:
- 1
- 1
- 1
- 1
- 1
- 1
- 1
- 1
199 SPARTANBURG HWY
310 BUSINESS PKWY STE D
145 N CHURCH ST STE 504
745 LANDERS RD
364 S PINE ST STE B-205
195 BURDETTE ST
2375 E MAIN ST STE A101
945 E MAIN ST STE 5
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Limited Liability
IHCP-0717 / 05/31/2019
IHCP-0281 / 08/31/2019
IHCP-0350 / 11/30/2019
IHCP-0721 / 07/31/2019
IHCP-0120 / 04/30/2019
IHCP-0787 / 04/30/2019
IHCP-0243 / 06/30/2019
IHCP-0076 / 02/28/2019
LYMAN, SC 29365 FAC.#:864-485-3115
GREER, SC 29651-7118 FAC.#:888-345-1780
SPARTANBURG, SC 29304 FAC.#:864-764-4040
SPARTANBURG, SC 29303 FAC.#:336-610-8300
SPARTANBURG, SC 29302-2624 FAC.#:864-542-2893
SPARTANBURG, SC 29307-1003 FAC.#:864-562-2222
SPARTANBURG, SC 29307-1400 FAC.#:864-579-3346
SPARTANBURG, SC 29302-2119 FAC.#:864-573-2353
7281 NEW CUT RD
3165 SWEETEN CREEK RD
PO BOX 3233-29304
745 LANDERS RD
PO BOX 2875
195 BURDETTE ST
2375 E MAIN ST A101
945 E MAIN ST STE D
INMAN, SC 29349
ASHEVILLE, NC 28803-2115
SPARTANBURG, SC 29304
SPARTANBURG, SC 29303
SPARTANBURG, SC 29304
SPARTANBURG, SC 29307-1003
SPARTANBURG, SC 29307
SPARTANBURG, SC 29302-2119
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
A REMEDY HOME CARE LLC
AEROFLOW INC
AACSC LLC
ALL GENERATIONS HOME CARE INC
AXCESS HEALTHCARE SERVICES LLC
CHARLES LEA CENTER
CIRCLE OF ANGELS HOME HEALTH CARE LLC
KIKI'S KARE LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
20 hlfactcc.rdf
SpartanburgCounty:
Inhome Care ProviderFacility Type:
COMPLETE CARE MANAGEMENT SERVICES LLC
CORPORATE CARE LLC-SPARTANBURG
ELITE HOME CARE
FIRSTLIGHT HOMECARE OF SPARTANBURG COUNTY
GRISWOLD HOME CARE-GREENVILLE AND SPARTANBURG
HAPPY HOME CARE
HELPING HANDS HOME CARE OF SPARTANBURG
HOME INSTEAD SENIOR CARE OF SPARTANBURG AND CHEROKEE
COUNTIES
DOGAN SATREVA PH#: 864-517-0350
PH#:
PH#:
PH#:
PH#:
ROBINSON CHADRICK PH#: 864-426-4974
PH#:
PH#:
- 1
- 1
- 1
- 1
- 1
- 1
- 1
- 1
716 UNION ST
222 E BLACKSTOCK RD STE C
2000 BUD ARTHUR BRIDGE RD
145 N CHURCH ST STE 100A
205 LAKEWINDS BLVD
359 WHITNEY RD STE 9
1229 BOILING SPRINGS RD
1409 W O EZELL BLVD
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
IHCP-0724 / 07/31/2019
IHCP-0276 / 08/31/2019
IHCP-0030 / 10/31/2019
IHCP-0524 / 03/31/2019
IHCP-0202 / 06/30/2019
IHCP-0716 / 05/31/2019
IHCP-0504 / 03/31/2019
IHCP-0100 / 04/30/2019
SPARTANBURG, SC 29306 FAC.#:864-517-0350
SPARTANBURG, SC 29301-2627 FAC.#:864-327-8386
SPARTANBURG, SC 29307-4417 FAC.#:864-869-8730
SPARTANBURG, SC 29306 FAC.#:864-310-6796
INMAN, SC 29349-6988 FAC.#:864-990-0329
SPARTANBURG, SC 29303 FAC.#:864-586-5600
SPARTANBURG, SC 29303-2258 FAC.#:864-591-3043
SPARTANBURG, SC 29301 FAC.#:864-699-9525
PO BOX 1463
PO BOX 16148
PO BOX 1181
145 N CHURCH STREET BTC #53
205 LAKEWINDS BLVD
1208 HELMS RD
2811 REIDVILLE RD STE 28
SPARTANBURG, SC 29304
GREENVILLE, SC 29606-7148
SPARTANBURG, SC 29304-1181
SPARTANBURG, SC 29306
INMAN, SC 29349-6988
CHARLOTTE, NC 28214
SPARTANBURG, SC 29301-5672
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
COMPLETE CARE MANAGEMENT SERVICES OF SC LLC
CORPORATE CARE LLC
ELITE HOME CARE LLC
AJF PERSONAL HOME CARE SPECIALISTS LLC
HEART OF THE HOME LLC
HAPPY HOME CARE LLC
HELPING HANDS HOME CARE OF SPARTANBURG INC
3 HEARTS LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
21 hlfactcc.rdf
SpartanburgCounty:
Inhome Care ProviderFacility Type:
INTEGRYS HOME CARE
LEGACY HEALTHCARE ADVANTAGE
LOVING CARE OF SOUTH CAROLINA
PENCHANT HOME CARE SERVICES INC
RESCARE HOMECARE SPARTANBURG
SENIOR CARE CONSULTANTS OF SOUTH CAROLINA LLC
SUMMIT HILLS WELL CARE
UPSTATE HOME CARE SOLUTIONS - SPARTANBURG
PH#:
PH#:
PH#:
PH#:
YOUNG SHIRLEY PH#:
PH#:
FARGIS REGINA PH#: 864-591-2222
PH#:
- 1
- 1
- 1
- 1
- 1
- 1
- 1
- 1
378 S PINE STREET UNIT 5
101 N PINE ST STE 210
404 POWELL MILL RD STE B
9338 ASHEVILLE HWY
900 S PINE ST STE 200
110 DILLON DR
100 SUMMIT HILLS DR
1865 E MAIN ST
Spartanburg / Limited Liability
Spartanburg / Sole Proprietorship
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Limited Liability
IHCP-0894 / 05/31/2019
IHCP-0881 / 06/30/2019
IHCP-0231 / 07/31/2019
IHCP-0142 / 05/31/2019
IHCP-0016 / 06/30/2019
IHCP-0442 / 09/30/2019
IHCP-0402 / 09/30/2019
IHCP-0840 / 03/31/2019
SPARTANBURG, SC 29302 FAC.#:864-596-8804
SPARTANBURG, SC 29302 FAC.#:864-308-8712
SPARTANBURG, SC 29301-1554 FAC.#:864-587-9330
INMAN, SC 29349 FAC.#:864-599-9468
SPARTANBURG, SC 29302 FAC.#:864-585-9600
SPARTANBURG, SC 29307-1018 FAC.#:888-268-5319
SPARTANBURG, SC 29307-1532 FAC.#:864-591-2222
DUNCAN, SC 29334-8723 FAC.#:864-527-0455
404 POWELL MILL RD STE B
9338 ASHEVILLE HWY
900 S PINE ST
PO BOX 9173
110 SUMMIT HILLS DR
113 W ANTRIM DR
SPARTANBURG, SC 29301-1554
INMAN, SC 29349
SPARTANBURG, SC 29302-3362
SPARTANBURG, SC 29305-9173
SPARTANBURG, SC 29307
GREENVILLE, SC 29607
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
INTEGRYS HOME CARE LLC
WILKES CORTELLA
LOVING CARE OF SOUTH CAROLINA LLC
PENCHANT HOME CARE SERVICES INC
SOUTHERN HOME CARE SERVICES INC DBA RESCARE HOMECARE
SENIOR CARE CONSULTANTS OF SOUTH CAROLINA LLC
LIVE LONG WELL CARE LLC
UPSTATE HOME HEALTH CARE SOLUTIONS LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
22 hlfactcc.rdf
SpartanburgCounty:
Inhome Care ProviderFacility Type:
VISITING ANGELS OF SPARTANBURG
MAXEY JEANETTE PH#: 864-881-0520
- 1
609 E MAIN ST
Spartanburg / Limited Liability
IHCP-0658 / 12/31/2019
DUNCAN, SC 29334 FAC.#:864-881-0520
609 E MAIN ST
DUNCAN, SC 29334
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Activities/Facilities licensed: 25 Number Licensed Units: - 25
UPSTATE ANGELS LLC
Totals For Facility/License Type: Inhome Care Provider
Facility Email: [email protected]
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
23 hlfactcc.rdf
SpartanburgCounty:
Nursing HomeFacility Type:
GOLDEN AGE-INMAN
INMAN HEALTHCARE
LAKE EMORY POST ACUTE CARE
MAGNOLIA MANOR-INMAN
JOHNSON TIMOTHY A PH#: 864-472-6636
PH#:
CADDELL CASEY J PH#: 864-472-2028
ROSS-MERKEL MELISSA PH#: 864-472-9055
44
40
88
176
82 N MAIN ST
51 N MAIN ST
59 BLACKSTOCK RD
63 BLACKSTOCK RD
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Ltd. Liability
Spartanburg / Ltd. Liability
NCF-0857 / 12/31/2018 (Renewal Pending)
NCF-0864 / 12/31/2018 (Renewal Pending)
NCF-0862 / 08/31/2019
NCF-0863 / 08/31/2019
INMAN, SC 29349-1416 FAC.#:864-472-6636
INMAN, SC 29349-1437 FAC.#:864-472-9370
INMAN, SC 29349-1827 FAC.#:864-472-2028
INMAN, SC 29349-1849 FAC.#:864-472-9055
82 N MAIN ST
51 N MAIN ST
59 BLACKSTOCK RD
63 BLACKSTOCK RD
INMAN, SC 29349-1416
INMAN, SC 29349-1437
INMAN, SC 29349-1827
INMAN, SC 29349-1849
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:
44
40
88
176
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
0
0
0
0
INMAN GOLDEN AGE OPERATING COMPANY LLC
INMAN HEALTH OPERATING COMPANY LLC
THI OF SOUTH CAROLINA AT CAMP CARE LLC
THI OF SOUTH CAROLINA AT MAGNOLIA MANOR-INMAN LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
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
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
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
24 hlfactcc.rdf
SpartanburgCounty:
Nursing HomeFacility Type:
MAGNOLIA MANOR-SPARTANBURG
MOUNTAINVIEW NURSING HOME
PHYSICAL REHABILITATION AND WELLNESS CENTER OF
SPARTANBURG
ROSECREST REHABILITATION AND HEALTHCARE
WINN ANNE O PH#: 864-585-0218
DILLARD WILSON K PH#: 864-582-4175
PH#:
YETTER MELISSA PH#: 864-599-8600
95
132
120
75
375 SERPENTINE DR
340 CEDAR SPRINGS RD
8020 WHITE AVE
200 FORTRESS DR
Spartanburg / Ltd. Liability
Spartanburg / Corporation
Spartanburg / Ltd. Liability
Spartanburg / Non-Profit Corporation
NCF-0867 / 08/31/2019
NCF-0149 / 06/30/2019
NCF-0861 / 08/31/2019
NCF-0817 / 04/30/2019
SPARTANBURG, SC 29303-3026 FAC.#:864-585-0218
SPARTANBURG, SC 29302-4697 FAC.#:864-582-4175
SPARTANBURG, SC 29303-2099 FAC.#:864-542-8515
INMAN, SC 29349-9160 FAC.#:864-599-8600
375 SERPENTINE DR
340 CEDAR SPRINGS RD
8020 WHITE AVE
200 FORTRESS DR
SPARTANBURG, SC 29303-3026
SPARTANBURG, SC 29302-4697
SPARTANBURG, SC 29303-2099
INMAN, SC 29349-9160
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:
95
132
120
75
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
0
0
0
0
THI OF SOUTH CAROLINA AT SPARTANBURG LLC
COMMUNITY SERVICES FOR THE AGING INC
THI OF SOUTH CAROLINA AT MAGNOLIA PLACE AT SPARTANBURG LLC
LUTHERAN HOMES OF SOUTH CAROLINA INC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
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
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
25 hlfactcc.rdf
SpartanburgCounty:
Nursing HomeFacility Type:
SKYLYN NURSING AND REHABILITATION CENTER
SPARTANBURG HOSPITAL FOR RESTORATIVE CARE SNF
SUMMIT HILLS SKILLED NURSING FACILITY
VALLEY FALLS TERRACE
KENNEDY SHERRY S PH#: 864-582-6838
STIMAC PATRICIA M PH#: 864-560-3232
BECTON JOSHUA PH#: 864-591-2222
PH#:
44
25
33
88
1705 SKYLYN DR
389 SERPENTINE DR
100 SUMMIT HILLS DR
400 LOCUST GRV RD
Spartanburg / Limited Liability
Spartanburg / District
Spartanburg / Ltd. Liability
Spartanburg / Corporation
NCF-1008 / 08/30/2019
NCF-0915 / 02/28/2019
NCF-0950 / 03/31/2019
NCF-0495 / 02/28/2019
SPARTANBURG, SC 29307-1090 FAC.#:864-582-2833
SPARTANBURG, SC 29303-3074 FAC.#:864-560-3232
SPARTANBURG, SC 29307-1532 FAC.#:864-591-2222
SPARTANBURG, SC 29303-4898 FAC.#:864-503-0377
1775 HANCOCK ST STE 200
389 SERPENTINE DR
100 SUMMIT HILLS DR
400 LOCUST GRV RD
SAN DIEGO, CA 92110
SPARTANBURG, SC 29303-3074
SPARTANBURG, SC 29307-1532
SPARTANBURG, SC 29303-4898
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:
44
25
27
88
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
0
0
6
0
PACIFICA SKYLYN LLC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
SUMMIT HILLS LLC
SPARTANBURG HEALTH CARE LLC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
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
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
26 hlfactcc.rdf
SpartanburgCounty:
Nursing HomeFacility Type:
WHITE OAK AT NORTH GROVE
WHITE OAK ESTATES
WHITE OAK MANOR SPARTANBURG
WOODRUFF MANOR
NELSON ANDREW R PH#: 864-345-1700
CRISP SONIA A PH#: 864-579-7004
CECIL III O KENT PH#: 864-585-0241
TERRELL C ADAM PH#: 864-476-7092
132
88
60
88
290 N GROVE MEDICAL PARK DR
400 WEBBER RD
295 E PEARL ST
1114 E GEORGIA RD
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / Corporation
Spartanburg / District
NCF-0971 / 05/31/2019
NCF-0888 / 12/31/2019
NCF-0889 / 12/31/2019
NCF-1000 / 09/30/2019
SPARTANBURG, SC 29303-4222 FAC.#:864-345-1700
SPARTANBURG, SC 29307-2400 FAC.#:864-579-7004
SPARTANBURG, SC 29303-3666 FAC.#:864-585-0241
WOODRUFF, SC 29388 FAC.#:864-476-7092
290 N GROVE MEDICAL PARK DR
400 WEBBER RD
295 E PEARL ST
1114 E GEORGIA RD
SPARTANBURG, SC 29303-4222
SPARTANBURG, SC 29307-2400
SPARTANBURG, SC 29303-3606
WOODRUFF, SC 29388
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:
132
88
60
88
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
Institutional Nursing Home:
0
0
0
0
Number of Activities/Facilities licensed: 16 Number Licensed Units: 1,328
WHITE OAK AT NORTH GROVE INC
WHITE OAK ESTATES INC
WHITE OAK MANOR SPARTANBURG INC
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Totals For Facility/License Type: Nursing Home
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Certifications:
Certifications:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
Alzheimer Care:
None
None
None
None
Yes
No
No
No
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Alzheimer Unit:
Yes
Yes
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
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
27 hlfactcc.rdf
SpartanburgCounty:
PSAD OutpatientFacility Type:
BHG SPARTANBURG TREATMENT CENTER
PALMETTO CAROLINA TREATMENT CENTER
THE FORRESTER CENTER FOR BEHAVIORAL HEALTH
COPLIN LARRY PH#:
BARR JOSEPH PH#:
O'BRIEN SUSAN PH#:
1
1
1
239 ACCESS RD
325 INGLESBY PKWY UNIT F
187 W BROAD ST STE 200 AND 300
Spartanburg / Corporation
Spartanburg / Limited Liability
Spartanburg /
OTPN-0171 / 01/31/2020
OTPN-0117 / 03/31/2019
OTP-0024 / 08/31/2019
SPARTANBURG, SC 29303-1682 FAC.#:864-503-0207
DUNCAN, SC 29334-9117 FAC.#:864-433-8443
SPARTANBURG, SC 29306-3234 FAC.#:864-582-7588
8300 DOUGLAS AVE STE 750
1200 WOODRUFF RD STE A3
DALLAS, TX 75225-5856
GREENVILLE, SC 29607-5732
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Activities/Facilities licensed: 3 Number Licensed Units: 3
BHG XXXVIII LLC
PALMETTO CAROLINA TREATMENT CENTER LLC
THE FORRESTER CENTER FOR BEHAVIORAL HEALTH
Totals For Facility/License Type: PSAD Outpatient
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
Certifications:
Certifications:
Certifications:
Narcotics Treatment Program, Methodone Treatment Program
Narcotics Treatment Program, Methodone Treatment Program
None
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
28 hlfactcc.rdf
SpartanburgCounty:
Renal DialysisFacility Type:
CAROLINA DIALYSIS
DCI EAST SPARTANBURG
DCI LANDRUM
DCI SPARTANBURG
DCI WEST SPARTANBURG
DCI-WOODRUFF
NILSEN AMANDA PH#: 864-576-9999
ROBERTS RN ANN MARIE PH#: 864-445-7755
EDGE CYNTHIA PH#:
ROBERTS RN ANN MARIE PH#: 864-445-7755
DIXON BRITTANY PH#: 864-574-8828
ROBERTS RN ANN MARIE PH#: 864-445-7755
23
35
13
43
25
13
115 INTERSTATE PARK
155 DILLON DR
110 ASBURY DR
203 E FREMONT AVE
105 TRADD ST
251 S PEARSON ST
Spartanburg / Limited Liability
Spartanburg / Non-Profit Corporation
Spartanburg / Non-Profit Corporation
Spartanburg / Non-Profit Corporation
Spartanburg / Non-Profit Corporation
Spartanburg / Non-Profit Corporation
ERD-0171 / 09/30/2019
ERD-0022 / 11/30/2019
ERD-0106 / 06/30/2019
ERD-0030 / 01/31/2020
ERD-0062 / 03/31/2019
ERD-0229 / 08/31/2019
SPARTANBURG, SC 29303-6611 FAC.#:864-576-9999
SPARTANBURG, SC 29307-1017 FAC.#:864-585-4840
LANDRUM, SC 29356-1401 FAC.#:864-457-2435
SPARTANBURG, SC 29303-2932 FAC.#:864-585-2046
SPARTANBURG, SC 29301-5085 FAC.#:864-574-8828
WOODRUFF, SC 29388-1958 FAC.#:864-476-5625
115 INTERSTATE PARK
155 DILLON DR
110 ASBURY DR
203 FREMONT AVE
105 TRADD ST
SPARTANBURG, SC 29303-6611
SPARTANBURG, SC 29307-1017
LANDRUM, SC 29356-1401
SPARTANBURG, SC 29303-2932
SPARTANBURG, SC 29301-5085
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:
20
32
13
43
25
13
Peritoneal:
Peritoneal:
Peritoneal:
Peritoneal:
Peritoneal:
Peritoneal:
3
6
0
0
0
0
CAROLINA DIALYSIS LLC
DIALYSIS CLINIC INC
DIALYSIS CLINIC INC
DIALYSIS CLINIC INC
DIALYSIS CLINIC INC
DIALYSIS CLINIC INC
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
29 hlfactcc.rdf
SpartanburgCounty:
Renal DialysisFacility Type:
SPARTANBURG DIALYSIS
U S RENAL CARE LYMAN DIALYSIS
WOFFORD DIALYSIS
MYERS ROBIN PH#: 803-865-0554
BRAGG RENEE PH#: 864-439-2138
BOWSER DEBRA PH#: 864-466-2129
24
14
14
128 DILLON DR
208 HOLLY SPRINGS RD
8024 WHITE AVE
Spartanburg / Limited Liability
Spartanburg / Corporation
Spartanburg / Limited Liability
ERD-0196 / 02/28/2019
ERD-0204 / 03/31/2019
ERD-0224 / 04/30/2019
SPARTANBURG, SC 29307-1018 FAC.#:864-587-1507
LYMAN, SC 29365-1314 FAC.#:864-439-2138
SPARTANBURG, SC 29303-2099 FAC.#:864-583-4798
128 DILLON DR
PO BOX 251549
5200 VIRGINIA WAY, L & C DEPARTMENT
SPARTANBURG, SC 29307-1018
PLANO, TX 75025-1500
BRENTWOOD, TN 37027
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Activities/Facilities licensed: 9 Number Licensed Units: 204
Licensed Stations:
Licensed Stations:
Licensed Stations:
Hemodialysis:
Hemodialysis:
Hemodialysis:
21
13
11
Peritoneal:
Peritoneal:
Peritoneal:
3
0
3
SPARTANBURG DIALYSIS LLC
DIALYSIS NEWCO INC
KANDUNCE DIALYSIS LLC
Totals For Facility/License Type: Renal Dialysis
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
30 hlfactcc.rdf
SpartanburgCounty:
Tattoo FacilityFacility Type:
BEARDED BROTHERS TATTOO CO
BLACK ROSE TATTOO STUDIO
BLOOD MONEY TATTOO STUDIO
CHASTAIN TATTOO
EYE POLLUTION CUSTOM TATTOO
GALLERY TATTOO
GOODFELLAS TATTOO
HONOR AND GLORY TATTOO
UPTON KEVIN PH#: 864-848-3361
WISE JAMIE PH#:
BUCKNER BRYAN C PH#: 828-243-6431
PH#:
ASHBY JAMES PHILLIP PH#: 803-447-4659
GALLAGHER DEWAYNE D PH#: 864-546-1406
BIRCH MARILYN S PH#: 864-497-2468
DUNCAN ADDAM K PH#: 828-279-6450
5
5
3
3
4
7
5
3
642 LEONARD RD
111 S MAIN ST
227 N CHARLOTTE HWY
7119-B LONE OAK RD
2250 BOILING SPRINGS RD
3295 REIDVILLE RD
2929B BOILING SPRINGS RD
13041 ASHEVILLE HWY STE C
Spartanburg / Limited Liability
Spartanburg / Sole Proprietorship
Spartanburg /
Spartanburg / Sole Proprietorship
Spartanburg / Limited Liability
Spartanburg / Limited Liability
Spartanburg / Sole Proprietorship
Spartanburg / Sole Proprietorship
TF-0082 / 06/30/2019
TF-0284 / 08/31/2019
TF-0314 / 09/30/2019
TF-0177 / 10/31/2019
TF-0170 / 08/31/2019
TF-0142 / 09/30/2019
TF-0288 / 04/30/2019
TF-0131 / 01/31/2020
DUNCAN, SC 29334-9483 FAC.#:864-848-3361
WOODRUFF, SC 29388 FAC.#:864-670-9650
LYMAN, SC 29365 FAC.#:828-243-6431
SPARTANBURG, SC 29303-1828 FAC.#:864-357-0892
BOILING SPRINGS, SC 29316 FAC.#:864-285-4548
SPARTANBURG, SC 29301-6124 FAC.#:864-542-4121
BOILING SPRINGS, SC 29316 FAC.#:864-707-5865
INMAN, SC 29349-7687 FAC.#:864-472-9275
642 LEONARD RD
227 N CHARLOTTE HWY
510 YORKTOWN PL
2250 BOILING SPRINGS RD
3295 REIDVILLE RD
2929B BOILING SPRINGS RD
13041C ASHEVILLE HWY
DUNCAN, SC 29334-9483
LYMAN, SC 29365
MOORE, SC 29369-9367
BOILING SPRINGS, SC 29316
SPARTANBURG, SC 29301-6124
BOILING SPRINGS, SC 29316
INMAN, SC 29349
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
BEARDED BROTHERS TATTOO CO LLC
WISE HOLLY BLAIR
BRYAN C BUCKNER
CHASTAIN JAY
EYE POLLUTION CUSTOM TATTOO LLC
GALLERY TATTOO AND PIERCING LLC
BIRCH MARILYN S
DUNCAN ADDAM K
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
31 hlfactcc.rdf
SpartanburgCounty:
Tattoo FacilityFacility Type:
INK KINGZ
LADY LIBERTY TATTOO PARLOR-LYMAN
LUCKY DICE TATTOO II
MADHOUSE TATTOO
NINE LIVES TATTOO
PALMETTO INK CUSTOM TATTOOS
PERSECUTED TATTOO
REBEL INK TATTOO
FENNER QUINTRINA PH#: 864-285-4109
BIBLE JASON S PH#: 864-505-8420
OSPINO RAPHAEL A PH#: 864-202-1094
SMITH PERRY PH#: 864-909-9822
PH#:
DELLINGER RHONDA S PH#: 864-327-5092
HUGHES ISRAEL PH#: 864-546-8204
PH#:
1
5
3
2
3
2
5
10
8009 WHITE AVE
109 SPARTANBURG HWY STE B
127 S BLACKSTOCK STE A
3417 BOILING SPRINGS RD
8000 HWY 9 STE 4
1517 ASHEVILLE HWY
1788 E POINSETT ST EXT STE C
1640 E MAIN ST
Spartanburg /
Spartanburg / Limited Liability
Spartanburg / Sole Proprietorship
Spartanburg / Sole Proprietorship
Spartanburg / Sole Proprietorship
Spartanburg / Limited Liability
Spartanburg / Sole Proprietorship
Spartanburg / Sole Proprietorship
TF-0194 / 03/31/2019
TF-0159 / 10/31/2019
TF-0141 / 06/30/2019
TF-0290 / 03/31/2019
TF-0277 / 07/31/2019
TF-0164 / 01/31/2019
TF-0150 / 02/28/2019
TF-0265 / 04/30/2019
SPARTANBURG, SC 29303-2042 FAC.#:864-285-4109
LYMAN, SC 29365 FAC.#:864-433-9655
SPARTANBURG, SC 29301-1361 FAC.#:864-804-6052
BOILING SPRINGS, SC 29316-6019 FAC.#:864-707-5304
INMAN, SC 29349 FAC.#:864-308-1912
SPARTANBURG, SC 29303-2005 FAC.#:864-327-5092
GREER, SC 29651-6336 FAC.#:864-420-6211
DUNCAN, SC 29334-9706 FAC.#:864-249-6400
8009 WHITE AVE
109 SPARTANBURG HWY STE B
412 W BLACKSTOCK RD
3417 BOILING SPRINGS RD
1517 ASHEVILLE HWY
1020 SHEILA AVE
SPARTANBURG, SC 29303-2042
LYMAN, SC 29365
SPARTANBURG, SC 29301-1361
BOILING SPRINGS, SC 29316-6019
SPARTANBURG, SC 29303-2005
GREER, SC 29651-5654
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
INK KINGZ LLC
LADY LIBERTY TATTOO PARLOR LLC
OSPINO RAPHAEL A
SMITH PERRY
TEAGUE BRANDON
PALMETTO INK CUSTOM TATTOOS LLC
HUGHES ISRAEL
HUNTER MICHAEL B
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Facility Email:
Licensed
Units
South Carolina Department of Health & Environmental Control
Division of Health Licensing
January 9, 2019
32 hlfactcc.rdf
SpartanburgCounty:
Tattoo FacilityFacility Type:
TATTOO WAREHOUSE
TRUTH-N-ART TATTOO AND ART GALLERY
PH#:
OLLISON MIKHAIL PH#:
6
4
2799 REIDVILLE RD
482 E BLACKSTOCK RD
Spartanburg / Sole Proprietorship
Spartanburg /
TF-0289 / 02/28/2019
TF-0300 / 10/31/2019
SPARTANBURG, SC 29301 FAC.#:864-586-1150
SPARTANBURG, SC 29301 FAC.#:864-586-5007
482 E BLACKSTOCK RD
SPARTANBURG, SC 29301
Facility NameLocation StreetLocation City, State Administrator/Phone License Nbr/Expiration Date
County/Ownership TypeMailing/Billing AddressLicensee
Number of Activities/Facilities licensed: 18 Number Licensed Units: 76
Number of Activities/Facilities licensed in county of :
Number Licensed Units : 4,286
ROBERTS JAMES LEE
TRUTH-N-ART TATTOO AND ART GALLERY
Totals For Facility/License Type: Tattoo Facility
Total Number of Activities/Facilities licensed: 128 Total Number Licensed Units: 4,286
Report Totals
Spartanburg 128# Lics:
Facility Email:
Facility Email:
Licensed
Units
