Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Excalibur Youth Services, LLC

Organization Family Medicine Physician · NPI 1487174462

Excalibur Youth Services, LLC is a Family Medicine Physician in Simpsonville, South Carolina. Licensed in South Carolina. Registered with an NPI since 2017.

Licensed in
SC
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3683 S Industrial Dr
Simpsonville, SC 29681-3238
Phone: (864) 836-7220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (SC)

Record details

NPI number1487174462
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Short — Ceo · (864) 836-7220
NPI enumeratedJune 21, 2017
Last updated in NPPESJune 21, 2017
Mailing addressPo Box 968, Travelers Rest, SC 29690-0968

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