11D2054559 CLIA NUMBER - TANGU, INC

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Laboratory Demographics

CLIA Number: 11D2054559

Facility Name: TANGU, INC

Facility Address:
1820 WATER PL, SE, SUITE #250
ATLANTA, GA
ZIP 30339
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Facility Phone Number: 404 523-4599

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1699890640

Taxonomy: 101Y00000X - Counselor
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

CLIA Record

Field Name	Field Value
CLIA Number	11D2054559
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	TANGU, INC
Street	1820 WATER PL, SE, SUITE #250
City	ATLANTA
State	GA
ZIP	30339
Phone	404 523-4599
CertificateType	4
CertificateEffectiveDate	2/25/2023
CertificateExpirationDate	2/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024