Excalibur Youth Services, LLC

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1710063375

Excalibur Youth Services, LLC is a Mental Illness Community Based Residential Treatment Facility in Greenville, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in: SC
In the registry since: 2006
Specialties on file: 2

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

5321 Old Buncombe Rd
Greenville, SC 29609-0910
Phone: (864) 679-0023
Fax: (864) 294-1774

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary)	Taxonomy 322D00000X · Licence SR-0009711001-CCI (SC)
Mental Illness Community Based Residential Treatment Facility	Taxonomy 320800000X

Record details

NPI number	1710063375
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Marvin Short — Member · (864) 679-0023
NPI enumerated	October 27, 2006
Last updated in NPPES	March 11, 2008
Mailing address	Po Box 968, Marietta, SC 29661-0968