| Organization Name: | EXCALIBUR YOUTH SERVICES, LLC. |
| NPI Number: | 1083852511 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN M. SHORT (MEMBER) |
| Mailing Address: | 3683 S. Industrial Dr. Simpsonville |
| State: | SC US |
| Postal Code: | 29681 |
| Phone Number: | 8646881133 |
| Fax Number: | 8649626976 |
| NPI Enumeration Date: | 01/21/2009 |
| NPI Last Update Date: | 01/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 323P00000X |
| License Number: | RTF-0022 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Psychiatric Residential Treatment Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient |