Organization Name: | QUALITY ADDICTION MANAGEMENT |
NPI Number: | 1659522613 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH ANN GILBERT (ADMINISTRATOR) |
Mailing Address: | 1610 Miller Park Way West Milwaukee |
State: | WI US |
Postal Code: | 532143604 |
Phone Number: | 4146723801 |
Fax Number: | 4146726026 |
NPI Enumeration Date: | 10/08/2008 |
NPI Last Update Date: | 10/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM2800X |
License Number: | 2236 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Methadone Clinic |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |