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Organization

MAGNOLIA HAVEN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HINSENE SAMSON (OWNER)
(980) 239-9535
Entity
Organization

Contact information

Practice address
2512 WESTHAMPTON DR, CHARLOTTE, NC 28208-6050
(980) 239-9535
Mailing address
1225 LOUISE AVE, CHARLOTTE, NC 28205-2852

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
05/11/2026
Last updated
05/11/2026
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