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WILLOW RESIDENTIAL LLC
NPI 1154252203
Residential Treatment Facility, Emotionally Disturbed Children in Charlotte, NC

Active since May 27, 2026
2631 KENHILL DR, CHARLOTTE, NC 28208(704) 749-4564 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Willow Residential Llc NPPES

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

WILLOW RESIDENTIAL LLC (NPI 1154252203) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Charlotte, North Carolina and active in the NPI registry since May 2026. The organization lists Amantii Samson, Owner, as its authorized official.

NPPES Registry Identity

NPI1154252203
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameWILLOW RESIDENTIAL LLC
Location Address2631 KENHILL DRCharlotte, NC 28208-5912
Mailing Address2631 Kenhill DrCharlotte, NC 28208-5912
Phone(704) 749-4564
Organization SubpartNo
Authorized OfficialAmantii SamsonOwner · (704) 749-4564
Enumeration DateMay 27, 2026
NPPES CertifiedMay 27, 2026
✔ NPI 1154252203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
2631 KENHILL DR, Charlotte, NC 28208
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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 Willow Residential LLC's NPI number?

The NPI number for Willow Residential LLC is 1154252203. It was assigned to this organization in the NPPES registry on May 27, 2026.

Where is Willow Residential LLC located?

Willow Residential LLC is located at 2631 Kenhill Dr, Charlotte, NC 28208. The listed phone number is (704) 749-4564.

What is Willow Residential LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Willow Residential LLC was last updated on May 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.