Magnolia Haven LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

MAGNOLIA HAVEN LLC

Practice address

2512 Westhampton Dr
Charlotte, NC 28208-6050

Phone

(980) 239-9535

NPI assigned

May 11, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hinsene Samson

Title

Owner

Phone

(980) 239-9535

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1508794520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 LOUISE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 WESTHAMPTON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282086050",
            "telephone_number": "980-239-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "HINSENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-239-9535"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ansleigh Magers
• Elise Ann Maggioncalda, MD
• Christyn Francesca Magill, MD
• Henry Maglente
• Tessabella Michelina Magliochetti, MD
• Magnolia'S Family in Care
• Laura K Magnuson, M.D.
• Magnusson Clinic PLLC
• Andreas Wallentin Magnusson, MD
• Shanna Mago, PMHNP-BC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.