NPIMap

Organization Active NPI

Quality Addiction Management

  • Methadone Clinic
  • West Milwaukee, WI
National Provider Identifier
1659522613
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
2236 Issued in WI
Legal business name
QUALITY ADDICTION MANAGEMENT
Practice address
1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone
(414) 672-3801
Fax
(414) 672-6026
NPI assigned
Oct 8, 2008
Last updated
Oct 8, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
QUALITY ADDICTION MANAGEMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Elizabeth Ann Gilbert, RNNPI 1871707422
Title
Administrator
Phone
(262) 549-6600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 2236 WI Primary

Addresses

Primary practice location

1610 Miller Park Way
West Milwaukee, WI 53214-3604

Mailing address

1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone (414) 672-3801

Other identifiers 2

IdentifierTypeStateIssuer
42234200MedicaidWI
42030800MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Sheboygan Comprehensive Treatment Center8 organizations share this tax ID, including this one
Part of
Sheboygan Comprehensive Treatment Center

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1610 Miller Park Way
West Milwaukee, WI 53214
Phone (414) 672-3801

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1659522613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-672-3801",
            "fax_number": "414-672-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-672-3801",
            "fax_number": "414-672-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY ADDICTION MANAGEMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUALITY ADDICTION MANAGEMENT",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-549-6600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "WI",
            "license": "2236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42234200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42030800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.