MEDICARE: MR. ERIC STIRGUS JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	WI
2	101YM0800X	Mental Health Counselor	WI
3	385H00000X	Respite Care	WI
4	385HR2055X	Child Mental Illness Respite Care	WI
5	320800000X	Mental Illness Community Based Residential Treatment Facility	WI
6	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	WI
7	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care	WI
8	251S00000X	Community/Behavioral Health Agency	WI
9	385HR2065X	Child Physical Disabilities Respite Care	WI

General Provider Information

NPI Number	:	1407704307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC STIRGUS JR.

Provider Business Mailing Address
First Line	:	7326 W SILVER SPRING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-2849
Country	:	US
Telephone Number	:	414-349-6170
Fax Number	:

Provider Business Practice Location Address
First Line	:	4072 N 12TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-7008
Country	:	US
Telephone Number	:	414-349-6170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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