VENICE PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY
NPI 1083852511
Psychiatric Residential Treatment Facility in Simpsonville, SC

Active since January 21, 2009
3683 S. INDUSTRIAL DR., SIMPSONVILLE, SC 29681(864) 688-1133(864) 962-6976 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 22, 2023, Apr 20, 2022, Feb 1, 2021 (3 updates tracked since 2021).

About Venice Psychiatric Residential Treatment Facility NPPES

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

VENICE PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY (NPI 1083852511) is a healthcare organization registered as a psychiatric residential treatment facility in Simpsonville, South Carolina and active in the NPI registry since January 2009. The organization maintains 2 additional practice locations and lists Isabelle Williams, Manager, Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1083852511
Entity TypeOrganization
Primary Taxonomy323P00000X
Legal Business NameEXCALIBUR YOUTH SERVICES, LLC.
Location Address3683 S. INDUSTRIAL DR.Simpsonville, SC 29681
Mailing AddressPo Box 18346Palatine, IL 60055-0968 · (919) 703-2829 · Fax (864) 294-1774
Fax(864) 962-6976
Organization SubpartNo
Authorized OfficialIsabelle WilliamsManager, Revenue Cycle · (919) 703-2829
Enumeration DateJanuary 21, 2009
Last NPPES UpdateAugust 22, 20233 updates tracked since enumeration
NPPES CertifiedAugust 22, 2023
NPI 1083852511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatric Residential Treatment FacilityResidential Treatment Facilities
Taxonomy Code323P00000X
License Licensed in SC · RTF-0022
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's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
3683 S. INDUSTRIAL DR., Simpsonville, SC 29681

Other Names 2

Doing Business AsVenice Psychiatric Residential Treatment Facility
Doing Business AsBroadstep Academy-sc Inc

Secondary Practice Locations 2

Location 11370 N Williamsburg County HwyKingstree, SC 29556-7027 · Phone (864) 836-7220
Location 2404 Hampton AvePickens, SC 29671-2608 · Phone (864) 679-0023 · Fax (864) 294-1774

Other Identifiers 2

OtherRTF-0022SC · South Carolina Department Of Health And Environment Control
MedicaidRTF055SC

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 1083852511. It was assigned to this organization in the NPPES registry on January 21, 2009. The provider is doing business as Venice Psychiatric Residential Treatment Facility and Broadstep Academy-SC Inc.

Where is Excalibur Youth Services, LLC. located?

Excalibur Youth Services, LLC. is located at 3683 S. Industrial Dr., Simpsonville, SC 29681. The listed phone number is (864) 688-1133.

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

The primary specialty registered for this NPI is Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.

When was this NPI record last updated?

The NPPES record for Excalibur Youth Services, LLC. was last updated on August 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.