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Mary L Mccullers-jackson
Mental Illness Community Based Residential Treatment Facility in Zebulon, North Carolina
NPI 1912021486

Mary L Mccullers-jackson is a Mental Illness Community Based Residential Treatment Facility based in Wendell, NC. Mary L Mccullers-jackson practices in Zebulon, NC. The NPI Number for Mary L Mccullers-jackson is 1912021486 and holds a License No. MHL092516 (North Carolina).

The current practice location address for Mary L Mccullers-jackson is 501 Bunn St, Zebulon, NC and can be reached out via phone at 919-269-3060 and via fax at 919-266-7901.

Location: 501 Bunn St, Zebulon, NC, 27591-7901
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912021486
Provider Name
Mary L Mccullers-jackson
Credential
Provider Entity Type
Organization
Address
501 Bunn St, Zebulon, NC, 27591-7901
Phone Number
919-269-3060
Fax Number
919-266-7901
Provider Enumeration Date
03/19/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
501 Bunn St
City
Zebulon
State
North Carolina
Zip
27597-9177
Phone Number
919-269-3060
Fax Number
919-266-7901
person
Provider Business Mailing Address Details
Address
501 Bunn St
City
Zebulon
State
North Carolina
Zip
27597-9177
Phone Number
919-269-3060
Fax Number
919-266-7901
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
311ZA0620X
License No.
MHL 092 516 (North Carolina)
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
MHL092516 (North Carolina)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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