MEDICARE: TANGU, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101Y00000X	Counselor	GA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	GA
3	101YM0800X	Mental Health Counselor	GA
4	101YP2500X	Professional Counselor	GA
5	104100000X	Social Worker	GA
6	1041C0700X	Clinical Social Worker	GA
7	106H00000X	Marriage & Family Therapist	GA
8	251B00000X	Case Management Agency	GA
9	251S00000X	Community/Behavioral Health Agency	GA
10	324500000X	Substance Abuse Rehabilitation Facility	GA
11	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1114042132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANGU, INC

Provider Business Mailing Address
First Line	:	227 SANDY SPRINGS PL # D-298
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-5918
Country	:	US
Telephone Number	:	404-697-7750
Fax Number	:	404-420-2893

Provider Business Practice Location Address
First Line	:	1820 WATER PL SE STE 250
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2287
Country	:	US
Telephone Number	:	404-523-4599
Fax Number	:	404-586-0645

Authorized Official
Title or Position	:	PRESIDENT, CEO
Name	:	DR. WALTER D BROOKS
Credential	:	PH.D., SAP
Telephone Number	:	404-697-7750

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/21/2022

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Directions to “TANGU, INC ” Practice Location

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