AZALEA WAY
NPI 1073032470
Community Based Residential Treatment Facility, Mental Illness in Hendersonville, NC

Q: What is Excalibur Youth Services, LLC.'s NPI number?

The NPI number for Excalibur Youth Services, LLC. is 1073032470. It was assigned to this organization in the NPPES registry on September 18, 2017. The provider is doing business as Azalea Way.

Q: What is Excalibur Youth Services, LLC.'s specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Active since September 18, 2017

145 AZALEA WAY, HENDERSONVILLE, NC 28792(864) 836-7220(864) 294-1774 Get Directions Write a Review

NPPES record last updated: September 18, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Azalea Way NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AZALEA WAY (NPI 1073032470) is a healthcare organization registered as a community based residential treatment facility, mental illness in Hendersonville, North Carolina and active in the NPI registry since September 2017. The organization lists Marvin John Short, Member, as its authorized official.

NPPES Registry Identity

NPI1073032470

Entity TypeOrganization

Primary Taxonomy320800000X

Legal Business NameEXCALIBUR YOUTH SERVICES, LLC.

Location Address145 AZALEA WAYHendersonville, NC 28792-2409

Mailing AddressPo Box 968Travelers Rest, SC 29690-0968 · (864) 836-7220 · Fax (864) 294-1774

Phone(864) 836-7220

Fax(864) 294-1774

Organization SubpartNo

Authorized OfficialMarvin John ShortMember · (864) 313-6967

Enumeration DateSeptember 18, 2017

✔ NPI 1073032470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities

Taxonomy Code320800000X

License✔ Licensed in NC · MHL045-119

Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

145 AZALEA WAY, Hendersonville, NC 28792

Open in Google Maps ↗

Other Names 1

Doing Business AsAzalea Way

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENNING AND ASSOCIATES INC

Residential Treatment Facility, Emotionally Disturbed Children

145 AZALEA WAY
HENDERSONVILLE, NC 28792

Henderson County (828) 693-5385

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Excalibur Youth Services, LLC.'s NPI number?

The NPI number for Excalibur Youth Services, LLC. is 1073032470. It was assigned to this organization in the NPPES registry on September 18, 2017. The provider is doing business as Azalea Way.

Where is Excalibur Youth Services, LLC. located?

Excalibur Youth Services, LLC. is located at 145 Azalea Way, Hendersonville, NC 28792. The listed phone number is (864) 836-7220.

What is Excalibur Youth Services, LLC.'s specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Excalibur Youth Services, LLC. was last updated on September 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.