OrganizationActive
Molina Healthcare of Wisconsin
NPI 1700022936 · Health Maintenance Organization · West Allis, WI
Provider details
- NPI number
- 1700022936
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Parent organization
- Molina Healthcare, Inc
- Organization subpart
- Yes
- Authorized official
- Stephen Harris, Plan President(414) 847-1765
- License
- 18011 (WI)
Specialties & taxonomies
Managed Care Organizations
Practice location
2400 S 102nd St
Suite 105
West Allis, WI 53227-2132
Phone: (414) 847-1766
Fax: (414) 847-1778
Approximate (ZIP-level) locationGet directions
Mailing address
2400 S 102nd St
West Allis, WI 53227-2132
Registry dates
- Enumerated
- 2008-12-17
- Last updated
- 2011-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.