Organization
STRESS MANAGEMENT & MENTAL HEALTH CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG ALLAN MODELL (OWNER)
(414) 962-9156
Entity
Organization
Contact information
Practice address
10201 W LINCOLN AVE, # 308, WEST ALLIS, WI 53227-2136
(414) 329-7000
(414) 329-7010
Mailing address
10201 W LINCOLN AVE, # 308, WEST ALLIS, WI 53227-2136
(414) 329-7000
(414) 329-7010
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42163900
—
WI
Enumeration date
08/31/2006
Last updated
02/11/2009
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