Willow Residential LLC
NPI 1154252203 · Emotionally Disturbed Childrens' Residential Treatment Facility · Charlotte, NC
Willow Residential LLC is a Emotionally Disturbed Childrens' Residential Treatment Facility organization in Charlotte, NC (NPI 1154252203).
Provider details
- NPI number
- 1154252203
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Amantii Samson, Owner(704) 749-4564
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2026-05-27
- Last updated
- 2026-05-27
- Certified
- 2026-05-27
Frequently asked questions
- What is Willow Residential LLC's NPI number?
- Willow Residential LLC's National Provider Identifier (NPI) is 1154252203, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Willow Residential LLC?
- Willow Residential LLC is classified in the NPPES registry as Emotionally Disturbed Childrens' Residential Treatment Facility (Residential Treatment Facilities).
- Where is Willow Residential LLC located?
- Willow Residential LLC's practice location on file with NPPES is 2631 Kenhill Dr, Charlotte, NC 28208-5912.
- What is Willow Residential LLC's phone number?
- The practice phone number listed in the NPPES registry for Willow Residential LLC is (704) 749-4564.
- Who is the authorized official for Willow Residential LLC?
- The authorized official listed on Willow Residential LLC's NPPES record is Amantii Samson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Willow Residential LLC's NPI active?
- Yes — Willow Residential LLC's NPI (1154252203) is active in the NPPES registry as of the last update on 2026-05-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.