Venice Psychiatric Residential Treatment Facility

LBN: Excalibur Youth Services, Llc.
Venice Psychiatric Residential Treatment Facility is an health care organization with primary practice located at 3683 S. Industrial Dr. , Simpsonville SC 29681. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. Excalibur Youth Services, Llc. can be contacted via phone (864) 688-1133, or through Williams, Isabelle via phone (919) 703-2829.

Contact Information

Primary practice address
3683 S. Industrial Dr. Simpsonville SC 29681
Phone: (864) 688-1133
Fax: (864) 962-6976
Website:
Map and Directions
Authorized official contact:
Name: Williams, Isabelle
Phone: (919) 703-2829

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X RTF-0022 South Carolina
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X

Profile Details

NPI number 1083852511
LBN Legal business name Excalibur Youth Services, Llc.
DBA Doing business as Venice Psychiatric Residential Treatment Facility
Authorized official Williams, Isabelle
Entity Organization
Organization subpart 1 No
Enumeration date Jan 21st, 2009
Last updated Aug 22nd, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1083852511 NPPES
South Carolina Other RTF-0022 SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENT CONTROL
South Carolina MEDICAID RTF055 SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENT CONTROL

Popular Providers