Azalea Way

LBN: Excalibur Youth Services, Llc.
Azalea Way is an health care organization with primary practice located at 145 Azalea Way , Hendersonville NC 28792-2409. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. Excalibur Youth Services, Llc. can be contacted via phone (864) 836-7220, or through Short, Marvin John via phone (864) 313-6967.

Contact Information

Primary practice address
145 Azalea Way Hendersonville NC 28792-2409
Phone: (864) 836-7220
Fax: (864) 294-1774
Website:
Map and Directions
Authorized official contact:
Name: Short, Marvin John JD
Phone: (864) 313-6967

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X MHL045-119 North Carolina

Profile Details

NPI number 1073032470
LBN Legal business name Excalibur Youth Services, Llc.
DBA Doing business as Azalea Way
Authorized official Short, Marvin John JD
Entity Organization
Organization subpart 1 No
Enumeration date Sep 18th, 2017
Last updated Sep 18th, 2017 - about 9 years ago

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.

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