Provider Demographics
NPI:1548881402
Name:BROOKE TANGEN HUUS, LLC
Entity type:Organization
Organization Name:BROOKE TANGEN HUUS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TANGEN HUUS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LAC
Authorized Official - Phone:303-385-5637
Mailing Address - Street 1:1776 S JACKSON ST STE 705
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3822
Mailing Address - Country:US
Mailing Address - Phone:303-385-5637
Mailing Address - Fax:
Practice Address - Street 1:1776 S JACKSON ST STE 705
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3822
Practice Address - Country:US
Practice Address - Phone:303-385-5637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKE TANGEN HUUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-01
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty