MEDICARE: TALL FAMILY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	320800000X	Mental Illness Community Based Residential Treatment Facility
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
3	323P00000X	Psychiatric Residential Treatment Facility
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558927590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALL FAMILY SERVICES, INC.

Provider Business Mailing Address
First Line	:	6021 LEBANON RD
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-8212
Country	:	US
Telephone Number	:	704-975-6118
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 LEBANON RD STE A2
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-8265
Country	:	US
Telephone Number	:	704-686-7171
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JESSE TALL
Credential	:
Telephone Number	:	704-975-6118

Provider Enumeration Date	:	05/15/2019
Last Update Date	:	06/18/2025

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