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RACINE COMPREHENSIVE TREATMENT CENTER
NPI 1457807091
Counselor - Addiction (Substance Use Disorder) in Racine, WI

Active since September 01, 2016CLIA 52D1033506 · Waiver
5735 DURAND AVE, A, RACINE, WI 53406(262) 598-1392(262) 598-1395 Get Directions Write a Review

NPPES record last updated: September 1, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Racine Comprehensive Treatment Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RACINE COMPREHENSIVE TREATMENT CENTER (NPI 1457807091) is a healthcare organization registered as an addiction (substance use disorder) in Racine, Wisconsin and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through November 8, 2026 and lists Kim Mason, Clinic Director, as its authorized official.

NPPES Registry Identity

NPI1457807091
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NameQAM
Location Address5735 DURAND AVE, ARacine, WI 53406-5011
Mailing Address5735 Durand Ave, ARacine, WI 53406-5011 · (262) 598-1392 · Fax (262) 598-1395
Phone(262) 598-1392
Fax(262) 598-1395
Organization SubpartNo
Authorized OfficialKim MasonClinic Director · (262) 598-1392
Enumeration DateSeptember 1, 2016
✔ NPI 1457807091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WI · 15532-132
5735 DURAND AVE, Racine, WI 53406
Open in Google Maps ↗

Other Names 1

Doing Business AsRacine Comprehensive Treatment Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D1033506

Quality Addiction Management, Inc Dba Racine Comprehensive Treatment Center · Racine, WI
Active · expires Nov 8, 2026
CLIA Number52D1033506
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2024
Certificate Expiration DateNovember 8, 2026
Laboratory DirectorDr. Jessica Kelderman
Laboratory Phone(262) 598-1392
Laboratory LocationQuality Addiction Management, Inc Dba Racine Comprehensive Treatment Center5735 Durand Ave, Suite A, Racine, WI 53406
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN M KLEBA RN
Registered Nurse
5735 DURAND AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 549-6600
LATEASHA NICOLE SAC
Counselor (Addiction (Substance Use Disorder))
5735 DURAND AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 598-1392
DANIELLE L JAMES
Licensed Practical Nurse
5735 DURAND AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 598-1392
ASHLEY DRAB
Registered Nurse
5735 DURAND AVE, SUITE A
RACINE, WI 53406
Racine County (262) 598-1392
NICOLE BERGEVAIN
Registered Nurse
5735 DURAND AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 598-1392
MR. ANDREWS KING NO. 16927 - 130
Counselor (Addiction (Substance Use Disorder))
5735 DURAND AVE, SUITE A
MOUNT PLEASANT, WI 53406
Racine County (262) 598-1392
HEATHERLY D AWAD LPN
Licensed Practical Nurse
5735 DURAND AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 598-1392
SHAMEKIA HARRELL SAC-IT
Counselor (Addiction (Substance Use Disorder))
5735 DURAND AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 598-1392

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Qam's NPI number?

The NPI number for Qam is 1457807091. It was assigned to this organization in the NPPES registry on September 1, 2016. The provider is doing business as Racine Comprehensive Treatment Center.

Where is Qam located?

Qam is located at 5735 Durand Ave A, Racine, WI 53406. The listed phone number is (262) 598-1392.

What is Qam's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Does Qam hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D1033506) is associated with this NPI, valid through November 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Qam was last updated on September 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.