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Excalibur Youth Services, Llc.
Emotionally Disturbed Childrens' Residential Treatment Facility in Greenville, South Carolina
NPI 1710063375

Excalibur Youth Services, Llc. is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Marietta, SC. Excalibur Youth Services, Llc. practices in Greenville, SC. The NPI Number for Excalibur Youth Services, Llc. is 1710063375 and holds a License No. (South Carolina).

The current practice location address for Excalibur Youth Services, Llc. is 5321 Old Buncombe Rd, Greenville, SC and can be reached out via phone at 864-679-0023 and via fax at 864-294-1774.

Location: 5321 Old Buncombe Rd, Greenville, SC, 29661-0968
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1710063375
Provider Name
Excalibur Youth Services, Llc.
Credential
Provider Entity Type
Organization
Address
5321 Old Buncombe Rd, Greenville, SC, 29661-0968
Phone Number
864-679-0023
Fax Number
864-294-1774
Provider Enumeration Date
10/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
907MXH 05 SC
institution
Provider Business Practice Location Address Details
Address
5321 Old Buncombe Rd
City
Greenville
State
South Carolina
Zip
29609-0910
Phone Number
864-679-0023
Fax Number
864-294-1774
person
Provider Business Mailing Address Details
Address
5321 Old Buncombe Rd
City
Greenville
State
South Carolina
Zip
29609-0910
Phone Number
864-679-0023
Fax Number
864-294-1774
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
SR-0009711001-CCI (South Carolina)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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