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42D0677056 CLIA NUMBER - TOTAL CARE HOME HEALTH OF SOUTH CAROLINA, INC DBA KINDRED AT HOME

Laboratory Demographics

CLIA Number: 42D0677056

Facility Name: TOTAL CARE HOME HEALTH OF SOUTH CAROLINA, INC DBA KINDRED AT HOME

Facility Address:
1240 21ST AVENUE NORTH, SUITE 200
MYRTLE BEACH, SC
ZIP 29577
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Facility Phone Number: 843 448-7060

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1821027962

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 42D0677056
LAB Type Home Health Agency
Facility Name TOTAL CARE HOME HEALTH OF SOUTH CAROLINA, INC DBA KINDRED AT HOME
Street 1240 21ST AVENUE NORTH, SUITE 200
City MYRTLE BEACH
State SC
ZIP 29577
Phone 843 448-7060
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024