Organization
MARY'S MANOR II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY LILLY MCCULLERS (OWNER ADMINISTRATOR)
(919) 266-5291
Entity
Organization
Contact information
Practice address
501 BUNN ST, ZEBULON, NC 27597-9177
(919) 796-5780
(919) 266-7901
Mailing address
5641 QUAIL COVEY LANE, WENDELL, NC 27591-7901
(919) 796-5780
(919) 266-7901
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
311ZA0620X
Adult Care Home Facility
MHL 092 460
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL 092 460
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/16/2007
Last updated
02/04/2025
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