Mary's Manor II

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MARY'S MANOR II

Practice address

501 Bunn St
Zebulon, NC 27597-9177

Phone

(919) 796-5780

Fax

(919) 266-7901

NPI assigned

Mar 16, 2007

Reactivated

Jul 9, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Mary Lilly McCullers

Title

Owner Administrator

Phone

(919) 266-5291

Specialties & licenses 5

Addresses

Tax ID family

Mary L McCullers-Jackson3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mary L McCullers-Jackson

  • Mental Illness Community Based Residential Treatment Facility
  • Zebulon, NC
  • NPI 1912021486
  NPD tax ID
• Marys Major III

  • Mental Illness Community Based Residential Treatment Facility
  • Raleigh, NC
  • NPI 1891819389
  NPD tax ID

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1326162363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5641 QUAIL COVEY LANE",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275917901",
            "telephone_number": "919-796-5780",
            "fax_number": "919-266-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BUNN ST",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275979177",
            "telephone_number": "919-796-5780",
            "fax_number": "919-266-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S MANOR II",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "deactivation_date": "2008-06-03",
        "reactivation_date": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "MCCULLERS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LILLY",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "919-266-5291",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL 092 460",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL 092 460",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Maniuszko, DPT
• Rebekah A Martin, P.T.
• Mary L McCullers-Jackson
• Mary Manor II
• Mary Manor II
• Henry Lawrence Mascarenhas, DNP
• Juliana Mathews, AUD
• Judy Westbrook Matthews
• Elizabeth Roberts Maynor, CCC-SLP
• Marcella T McCord, MD

• Community/Behavioral Health Agency in Zebulon, NC
• Providers in Zebulon, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.