DEPARTMENT OF HEALTH SERVICESDivision of Quality Assurance
STATE OF WISCONSINBureau of Health Services
PO Box 2969Madison, WI 53701-2969
Community Substance AbuseProgram Certification DirectoryBy County, City, and Provider Name
ADAMSFRIENDSHIP
2810ADAMS COUNTY HEALTH & HUMAN SERVICES DEPT COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201712/10/2008
(608) 339-4585
(608) [email protected] ELSE
County: AdamsFRIENDSHIP, WI 53934108 E NORTH STREET
CCS Affiliaton: 01/01/2016Begin: End: Lead:Central Wisconsin Health Partnership V2
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 03/01/2017 02/28/2019
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
1253ADAMS COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201809/01/1990
(608) 339-4585
(608) [email protected] SAARINEN-BARR
County: AdamsFRIENDSHIP, WI 53934108 E NORTH STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 03/01/2018 02/29/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 03/01/2018 02/29/2020
Services
Setting Begin/End DatesNon-Certified School Setting(s)03/01/2018 02/29/2020ADAMS/FRIENDSHIP ELEMENTARY SCHOOL, 500 N PIERCE ST, ADAMS, WI 53910
03/01/2018 02/29/2020ADAMS/FRIENDSHIP HIGH SCHOOL, 1109 E NORTH ST, ADAMS, WI 53910
03/01/2018 02/29/2020ADAMS/FRIENDSHIP MIDDLE SCHOOL, 420 N MAIN ST, ADAMS, WI 53910
ASHLANDASHLAND
2728BAD RIVER AODA PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201702/01/2007
(715) 685-7857
(715) [email protected] MOORE
County: AshlandASHLAND, WI 5480653585 NOKOMIS RD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2154BEHAVIORAL HEALTH SERVICES OF MEMORIAL MEDICAL CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201710/01/1999
(715) 685-5102
(715) [email protected] JENSEN
County: AshlandASHLAND, WI 548061635 MAPLE LANE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 10/01/2017 09/30/2019
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 10/01/2017 09/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 10/01/2017 09/30/2019
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 1 DHS 40.11(2)(A) 10/01/2017 09/30/2018
MENTAL HEALTH-INPATIENT DHS 61.71 10/01/2017 09/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2017 09/30/2019ASHLAND MIDDLE SCHOOL, 203 - 11TH STREET EAST, ASHLAND, WI 548063
10/01/2017 09/30/2019DRUMMOND AREA SCHOOL DISTRICT, 52440 EASTERN AVE, DRUMMOND, WI 548323
10/01/2017 09/30/2019LAKE SUPERIOR PRIMARY SCHOOL DISTRICT, 1101 BINSFIELD ROAD, ASHLAND, WI 548063
10/01/2017 09/30/2019NORTHLAND COLLEGE, 1411 ELLIS AVE, ASHLAND, WI 548063
3055NEW HORIZONS NORTH CCS - ASHLAND COUNTY
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/01/2015
(715) [email protected] LEVNO
County: AshlandASHLAND, WI 54806514 WEST MAIN STREET
CCS Affiliaton: 01/01/2015Begin: End: Lead:New Horizons North CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
1664NEW HORIZONS NORTH-COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201705/13/1991
(715) 682-7176
(715) [email protected] LEVNO
County: AshlandASHLAND, WI 54806514 W MAIN STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
BARRONBARRON
2640BARRON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201701/01/2006
(715) 537-6848
(715) [email protected] HAY
County: BarronBARRON, WI 54812335 EAST MONROE AVE ROOM 338
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
RICE LAKE
2925BARRON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/01/2010
(715) 537-6848
(715) [email protected] HAY
County: BarronRICE LAKE, WI 54868935 N MAIN ST, LOWER LEVEL
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 11/01/2017 10/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
BAYFIELDBAYFIELD
3157RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA CCS
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201804/01/201804/01/2017
(715) 779-3765
(715) [email protected] GURNOE
County: BayfieldBAYFIELD, WI 5481437390 NORTH BRADUM ROAD
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL POPULATION-BASED DHS 36 04/01/2018 09/30/2018
Services
NO BRANCH LOCATIONS
3143RED CLIFF COMMUNITY HEALTH CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201805/20/2016
(715) 779-3362
(715) [email protected] GURNOE
County: BayfieldBAYFIELD, WI 5481436745 AIKEN ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 04/01/2018 03/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2019MISHOMIS WELLNESS CENTER, 37390 N BRADUM ROAD, BAYFIELD, WI 548142
04/01/2018 03/31/2019RED CLIFF EARLY EDUCATION CENTER, 89830 TINY TOT DRIVE, BAYFIELD, WI 548143
06/26/2018 Page 4 of 172
Substance Abuse Program Directory By County, City, and Provider Name
IRON RIVER
1064NORTHLAKES COMMUNITY CLINIC AODA SERVICES
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/1984
(715) 372-5067
(715) [email protected] AKL
County: BayfieldIRON RIVER, WI 548477665 US HWY 2
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier05/16/2018 08/31/2018NORTHLAKES CLINIC - HAYWARD RIVERS EDGE, 15954 RIVERS EDGE DR, #121, HAYWARD, WI
548432
12/21/2016 08/31/2018NORTHLAKES COMMUNITY CLINIC - DOWNTOWN, 300 MAIN STREET WEST, ASHLAND, WI 548062
09/01/2016 08/31/2018NORTHLAKES COMMUNITY CLINIC - WASHBURN, 101 THOMPSON ROAD, WASHBURN, WI 548912
09/01/2016 08/31/2018NORTHLAKES COMMUNITY CLINIC, 214-A MAPLE ST SOUTH, TURTLE LAKE, WI 548892
09/01/2016 08/31/2018NORTHLAKES COMMUNITY CLINIC-MINONG MEDICAL CLINIC, 600 SHELL CREEK ROAD, MINONG, WI 54859
2
09/01/2016 08/31/2018ASHLAND HIGH SCHOOL, 1900 BEASER AVENUE, ASHLAND, WI 548063
09/01/2016 08/31/2018ASHLAND MIDDLE SCHOOL, 203 - 11TH STREET EAST, ASHLAND, WI 548063
08/24/2017 08/31/2018CLAYTON SCHOOL, 236 POLK AVENUE WEST, CLAYTON, WI 540043
08/24/2017 08/31/2018CLEAR LAKE JR/SR HIGH SCHOOL, 1101 THIRD ST SW, CLEAR LAKE, WI 540053
09/01/2016 08/31/2018LAKE SUPERIOR PRIMARY AND ELEMENTARY SCHOOLS, 1101 BINSFIELD ROAD, ASHLAND, WI 54806
3
08/24/2017 08/31/2018PRAIRIE FARM SCHOOL, 630 RIVER AVE S, PRAIRIE FARM, WI 547623
08/24/2017 08/31/2018TURTLE LAKE SCHOOL DISTRICT, 205 OAK STREET NORTH, TURTLE LAKE, WI 548893
12/27/2017 08/31/2018WASHBURN ELEMENTARY SCHOOL/ELC, 411 W 8TH STREET, WASHBURN, WI 548913
12/17/2017 08/31/2018WASHBURN MIDDLE/HIGH SCHOOL, 305 4TH AVENUE WEST, WASHBURN, WI 548913
08/24/2017 08/31/2018WOODLAND ELEMENTARY SCHOOL, 808 EAST WOODLAND AVE, BARRON, WI 548123
WASHBURN
3054NEW HORIZONS NORTH CCS - BAYFIELD COUNTY
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/01/2015
(715) 373-6130
(715) [email protected] LEVNO
County: BayfieldWASHBURN, WI 54891324 WEST BAYFIELD STREET
CCS Affiliaton: 01/01/2015Begin: End: Lead:New Horizons North CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
1663NEW HORIZONS NORTH-COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201703/01/1991
(715) 373-2203
(715) [email protected] LEVNO
County: BayfieldWASHBURN, WI 54891320 WEST SUPERIOR AVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2361NORTHLAND COUNSELING SERVICES
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201807/01/201607/01/2001
(715) 373-0162
(715) [email protected] LUND
County: BayfieldWASHBURN, WI 5489121 W OMAHA STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2016 06/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2016 06/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2016 06/30/2018NORTHLAND COUNSELING SERVICES LTD, 117 EAST SIXTH STREET, WASHBURN, WI 548911
07/01/2016 06/30/2018NORTHLAND COUNSELING SERVICES, 611 E WALL STREET, EAGLE RIVER, WI 545211
07/01/2016 06/30/2018NORTHLAND COUNSELING SERVICES, 1619 WEST THIRD STREET, ASHLAND, WI 548062
06/26/2018 Page 6 of 172
Substance Abuse Program Directory By County, City, and Provider Name
BROWNGREEN BAY
3029ACS CLINICAL SERVICES, LLC - GREEN BAY
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/16/2014
(920) 469-2580
(920) [email protected] SUMNER
County: BrownGREEN BAY, WI 543112670 UNIVERSITY AVE
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
3047BAETEN COUNSELING & CONSULTATION TEAM, S.C
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/06/2014
(920) 632-4315
(920) [email protected] BAETEN
County: BrownGREEN BAY, WI 543012920 S WEBSTER AVE, SUITE B
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1098BELLIN PSYCHIATRIC CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/01/1984
(920) 431-0333
(920) [email protected] COUNARD
County: BrownGREEN BAY, WI 54301301 E ST JOSEPH STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 04/01/2018 03/31/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 04/01/2018 03/31/2020
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 04/01/2018 03/31/2020
MENTAL HEALTH-INPATIENT DHS 61.71 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER - ALGOMA, 831 PARKER ST, ALGOMA, WI 542011
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER - BONDUEL, 401 E MILL ST, BONDUEL, WI 541071
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER - BRILLION, 964 W. RYAN ST., STE. B, BRILLION, WI 541101
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER, 575 - 4TH ST, KEWAUNEE, WI 542161
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER, 704 S. WEBSTER STE. #201, GREEN BAY, WI 543011
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER, 744 S WEBSTER AVE, GREEN BAY, WI 543011
04/01/2018 03/31/2020BELLIN HEALTH GENERATIONS, 720 S VAN BUREN ST #101, GREEN BAY, WI 543012
04/01/2018 03/31/2020BELLIN HEALTH RIVERSIDE PSYCHIATRIC GROUP, 1325 ANGELS PATH, DE PERE, WI 541152
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER - EAST DE PERE, 555 REDBIRD CIRCLE STE 100, DE PERE, WI 541152
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER - OCONTO FALLS, 107 E HIGHLAND DR, OCONTO FALLS, WI 541542
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER - STURGEON BAY, 311 N 3RD AVENUE, STURGEON BAY, WI 542352
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER-NEURO TEAM, 725 S WEBSTER, GREEN BAY, WI 543052
04/01/2018 03/31/2020BELLIN PSYCHIATRIC CENTER-W. DE PERE, 1800 LAWRENCE DR, DE PERE, WI 541152
04/01/2018 03/31/2020ALGOMA ELEMENTARY SCHOOL, 514 FREEMONT STREET, ALGOMA, WI 542013
04/01/2018 03/31/2020ALGOMA MIDDLE AND HIGH SCHOOL, 1715 DIVISION STREET, ALGOMA, WI 542013
04/01/2018 03/31/2020DR. ROSA MINOKA-HILL SCHOOL, 325 N ROOSEVELT, GREEN BAY, WI 543013
04/01/2018 03/31/2020HEMLOCK CREEK ELEMENTARY SCHOOL, 1900 WILLIAMS GRANT DR, DE PERE, WI 541153
04/01/2018 03/31/2020PHANTOM KNIGHT CHARTER - WEST ACADEMY, 400 REID ST, SUITE W, DE PERE, WI 541153
04/01/2018 03/31/2020WESTWOOD ELEMENTARY SCHOOL, 1155 WESTWOOD, DE PERE, WI 541153
2615BROWN COUNTY COMMUNITY TREATMENT CENTER COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201608/25/2005
(920) 391-4811
(920) [email protected] AGAR
County: BrownGREEN BAY, WI 543113150 GERSHWIN DRIVE
CCS Affiliaton: 01/01/2018Begin: End: Lead:Northeastern Regional CCS Consortium V2
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 09/01/2016 08/31/2018
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1117BROWN COUNTY COMMUNITY TREATMENT CTR
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201710/01/1975
(920) 391-4811
(920) [email protected] AGAR
County: BrownGREEN BAY, WI 543113150 GERSHWIN DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 09/01/2017 08/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2017 08/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 09/01/2017 08/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 09/01/2017 08/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 09/01/2017 08/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2019BROWN COUNTY HUMAN SVS YOUTH CLINIC, 111 NORTH JEFFERSON ST, GREEN BAY, WI 543052
2936BROWN COUNTY HUMAN SERVICES - DIVERSION
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201802/01/2011
(920) 448-6197
(920) [email protected] AGAR
County: BrownGREEN BAY, WI 543111311 DANZ AVE
Service Begin/End DatesAdm Code
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
2381BROWN COUNTY HUMAN SERVICES-CSP BROWN COUNTY COMMUNITY TREATMENT CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201706/24/2002
(920) 391-4811
(920) [email protected] AGAR
County: BrownGREEN BAY, WI 543113150 GERSHWIN DRIVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 09/01/2017 08/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1329FAMILY SERVICES OF NORTHEAST WISCONSIN, INC.
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201801/12/1996
(920) 432-5966
(920) [email protected] MISCHLER
County: BrownGREEN BAY, WI 54301300 CROOKS STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020BILLIE KRESS CENTER - YOUTH DEVELOPMENT, 3430 SPIRIT WAY, GREEN BAY, WI 543041
04/01/2018 03/31/2020FAMILY SERVICES - SOUTH IRWIN, 626 S IRWIN AVENUE, GREEN BAY, WI 543011
04/01/2018 03/31/2020WILLOW TREE, 503 S MONROE STREET, GREEN BAY, WI 543011
04/01/2018 03/31/2020EAST HIGH SCHOOL, 1415 E WALNUT ST, GREEN BAY, WI 543013
04/01/2018 03/31/2020WRIGHTSTOWN HIGH SCHOOL, 600 HIGH ST, WRIGHTSTOWN, WI 541803
04/01/2018 03/31/2020WRIGHTSTOWN MIDDLE SCHOOL, 400 SCHOOL ST, WRIGHTSTOWN, WI 541803
1035FOUNDATIONS HEALTH AND WHOLENESS
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201804/01/1981
(920) 437-1188
(920) [email protected] FELD
County: BrownGREEN BAY, WI 543031061 W MASON ST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2018 04/30/2020BOYS AND GIRLS CLUB, 1451 UNIVERSITY AVE, GREEN BAY, WI 543011
05/01/2018 04/30/2020BOYS AND GIRLS CLUB, 311 S. ONEIDA ST, GREEN BAY, WI 543031
05/01/2018 04/30/2020HOUSE OF HOPE, 1660 CHRISTIANA ST., GREEN BAY, WI 543031
05/01/2018 04/30/2020MICAH CENTER, 700 E. WALNUT ST., GREEN BAY, WI 543011
05/01/2018 04/30/2020NEW COMMUNITY CLINIC - NWTC, 2740 W. MASON ST., GREEN BAY, WI 543071
05/01/2018 04/30/2020NEW COMMUNITY CLINIC, 622 BODART ST, GREEN BAY, WI 543011
05/01/2018 04/30/2020NEW COMMUNITY SHELTER, 301 MATHER ST, GREEN BAY, WI 543011
05/01/2018 04/30/2020OUTREACH HEALTHCARE, 879 MATHER ST., GREEN BAY, WI 543031
Setting Begin/End DatesNon-Certified School Setting(s)05/01/2018 04/30/2020ALDO LEOPOLD SCHOOL, 1622 ELIZA ST, GREEN BAY, WI 54301
05/01/2018 04/30/2020BAY VIEW MIDDLE SCHOOL, 1217 CARDINAL LANE, GREEN BAY, WI 54313
05/01/2018 04/30/2020LINEVILLE INTERMEDIAE SCHOOL, 2706 LINEVILLE ROAD, GREEN BAY, WI 54313
2313INDEPENDENT ASSESSMENT & COUNSELING SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201807/01/201606/22/2001
(920) 438-7993
(920) [email protected] SANN
County: BrownGREEN BAY, WI 543031345 W MASON STREET, #201
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2016 06/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2016 06/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2988JACKIE NITSCHKE CENTER, INC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/24/201801/01/2013
(920) 435-2580
(920) [email protected] JOHNSEN
County: BrownGREEN BAY, WI 54301621 E WALNUT STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/24/2018 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/24/2018 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/24/2018 12/31/2018JACKIE NITSCHKE CENTER, INC. ADMIN OFFICES & FAM E, 700 CHERRY STREET, GREEN BAY, WI
543011
1446JACKIE NITSCHKE CENTER, INC.
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201706/05/1990
(920) 435-2580
(920) [email protected] JOHNSEN
County: BrownGREEN BAY, WI 54301630 CHERRY STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
1454KA'NI KUHLI'YO FAMILY CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201703/11/1993
(920) 490-3883
(920) [email protected] KRIESCHER
County: BrownGREEN BAY, WI 543032640 WEST POINT ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2017 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2017 01/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier02/01/2017 01/31/2019ANNA JOHN RESIDENT CENTERED CARE COMMUNITY, 2901 S OVERLAND, ONEIDA, WI 541551
02/01/2017 01/31/2019ONEIDA COMMUNITY HEALTH CENTER, 525 AIRPORT DRIVE, ONEIDA, WI 541551
02/01/2017 01/31/2019ONEIDA NATION VETERAN'S DEPARTMENT, 134 RIVERDALE DR., ONEIDA, WI 541551
02/01/2017 01/31/2019SEYMOUR HIGH SCHOOL SYSTEM, 10 CIRCLE DRIVE, SEYMOUR, WI 541651
02/01/2017 01/31/2019ONEIDA NATION ELEMENTARY SCHOOL, N7125 SEMINARY ROAD, ONEIDA, WI 541553
02/01/2017 01/31/2019ONEIDA NATION HIGH SCHOOL, N7210 SEMINARY ROAD, ONEIDA, WI 541553
12/01/2017 01/31/2019SEYMOUR HIGH SCHOOL SYSTEM, 10 CIRCLE DRIVE, SEYMOUR, WI 541653
1669NEW WELLNESS ASSOCIATES, INC.
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201706/01/1993
(920) 497-3135
(920) [email protected] HOWARD
County: BrownGREEN BAY, WI 543042733 S. RIDGE ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2017 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2017 05/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2017 05/31/2019NEW WELLNESS ASSOCIATES, INC., 1941 LEHRER LN, KAUKAUNA, WI 541301
06/26/2018 Page 11 of 172
Substance Abuse Program Directory By County, City, and Provider Name
2487QUALITY ADDICTION MANAGEMENT, INC DBA GREEN BAY COMPREHENSIVE TREATMENT CTR
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201610/20/2003
(920) 337-6741
(920) [email protected] NEERDAELS
County: BrownGREEN BAY, WI 543032357 W MASON ST
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
3116ST VINCENT HHS OF THE THIRD ORDER OF ST FRANCIS DBA LIBERTAS
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/2016
(920) 431-1996
(920) [email protected] DOXTATOR
County: BrownGREEN BAY, WI 543031701 DOUSMAN ST
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 03/01/2017 02/28/2019
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
1965VILLA HOPE COMMUNITY SUPPORT PROGRAM OF BROWN COUNTY
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201802/06/1996
(920) 469-5599
(920) [email protected] TOONEN
County: BrownGREEN BAY, WI 543111100 GUNS ROAD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
06/26/2018 Page 12 of 172
Substance Abuse Program Directory By County, City, and Provider Name
BURNETTSIREN
2633ACCESS INC COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/2006
(715) 349-7205
(715) [email protected] WOLF
County: BurnettSIREN, WI 5487224248 STATE ROAD 35/70 UNIT D
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 01/01/2018 12/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
WEBSTER
2217ST. CROIX TRIBAL BEHAVIORAL HEALTH CLINIC
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201805/01/2000
(715) 349-8528
(715) [email protected] CORMELL
County: BurnettWEBSTER, WI 548934404 STATE RD 70
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2018 04/30/2020ROUND LAKE CLINIC, 2230 - 60TH AVENUE, LUCK, WI 548531
06/26/2018 Page 13 of 172
Substance Abuse Program Directory By County, City, and Provider Name
CALUMETCHILTON
1120CALUMET COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201810/01/1975
(920) 849-1468
(920) [email protected] LECLAIR
County: CalumetCHILTON, WI 53014206 COURT STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 07/01/2018 06/30/2020
CSAS-EMERGENCY OUTPATIENT WITH TELEHEALTH DHS 75.05 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 07/01/2018 06/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020CALUMET COUNTY DEPT OF HUMAN SERVICES, 2306 S. ONEIDA STREET, APPLETON, WI 549152
2244CALUMET COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/2000
(920) 849-1468
(920) [email protected] LECLAIR
County: CalumetCHILTON, WI 53014206 COURT STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 07/01/2018 06/30/2020
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
2674CALUMET COUNTY DEPT OF HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201706/13/2006
(920) 849-1468
(920) [email protected] LECLAIR
County: CalumetCHILTON, WI 53014206 COURT STREET
CCS Affiliaton: 09/01/2014Begin: End: Lead:Northeastern Region CCS Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 07/01/2017 06/30/2019
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 14 of 172
Substance Abuse Program Directory By County, City, and Provider Name
CHIPPEWACHIPPEWA FALLS
2896CHIPPEWA AREA RECOVERY RESOURCE, LSS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/09/2010
(715) 726-9055
(715) [email protected] RODE
County: ChippewaCHIPPEWA FALLS, WI 54729127 WEST CENTRAL ST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2017 02/28/2019CHIPPEWA AREA RECOVERY RESOURCE, 122 S BARSTOW ST SUITE #1, EAU CLAIRE, WI 547011
2744COMMUNITY COUNSELING SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/14/2007
(715) 738-1214
(715) [email protected] ESLINGER
County: ChippewaCHIPPEWA FALLS, WI 5472916947 COUNTY HIGHWAY X
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
1475ST. JOSEPH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201801/12/1977
(715) 717-7504
(715) [email protected] SIMONSON
County: ChippewaCHIPPEWA FALLS, WI 547292661 COUNTY HIGHWAY I
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 02/01/2018 01/31/2020
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 02/01/2018 01/31/2020
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 02/01/2018 01/31/2020
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 02/01/2018 01/31/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2018 01/31/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 02/01/2018 01/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
3064WESTERN REGION RECOVERY AND WELLNESS CONSORTIUM - CSP
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201805/01/2015
(715) 726-7736
(715) [email protected] IVES
County: ChippewaCHIPPEWA FALLS, WI 54729711 N BRIDGE STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 05/01/2018 04/30/2020
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2018 04/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2018 04/30/2020BUFFALO COUNTY DEPT OF HEALTH & HUMAN SERVICES, 407 S. SECOND STREET, ALMA, WI
546101
05/01/2018 04/30/2020PEPIN COUNTY DEPT OF HUMAN SERVICES, 740 - 7TH AVE. WEST, DURAND, WI 547361
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Substance Abuse Program Directory By County, City, and Provider Name
3065WESTERN REGION RECOVERY AND WELLNESS CONSORTIUM-CCS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201804/01/2015
(715) 726-7736
(715) [email protected] IVES
County: ChippewaCHIPPEWA FALLS, WI 54729711 N BRIDGE STREET
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 04/01/2018 03/31/2019
CCS REGIONAL MODEL MULTI-COUNTY W/TELEHEALTH DHS 36 04/01/2018 03/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2019BARRON COUNTY DEPT. OF HEALTH & HUMAN SERVICES, 335 E. MONROE AVE., BARRON, WI
548122
04/01/2018 03/31/2019BUFFALO COUNTY DEPT. OF HEALTH & HUMAN SERVICES, 407 S SECOND ST, ALMA, WI 546102
04/01/2018 03/31/2019DUNN COUNTY DEPT OF HUMAN SERVICES, 3001 US HWY 12 E., STE. 160, MENOMONIE, WI 547512
04/01/2018 03/31/2019PEPIN COUNTY DEPT OF HUMAN SERVICES, 740 7TH AVE WEST, DURAND, WI 547362
04/01/2018 03/31/2019PIERCE COUNTY DEPT OF HUMAN SERVICES, 412 W. KINNE STREET, ELLSWORTH, WI 540112
04/01/2018 03/31/2019POLK COUNTY HUMAN SERVICES DEPARTMENT, 100 POLK COUNTY PLAZA, SUITE 50, BALSAM LAKE, WI 54810
2
04/01/2018 03/31/2019RUSK COUNTY DEPT. OF HEALTH & HUMAN SERVICES, 311 E MINER ST, LADYSMITH, WI 548482
04/01/2018 03/31/2019WASHBURN COUNTY DEPT OF HEALTH AND HUMAN SERVICES, 110 4TH AVENUE, SHELL LAKE, WI 54871
2
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Substance Abuse Program Directory By County, City, and Provider Name
CLARKNEILLSVILLE
1201CLARK COUNTY COMMUNITY SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/1984
(715) 743-5209
(715) [email protected] VOIGT
County: ClarkNEILLSVILLE, WI 54456517 COURT STREET RM 503
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019CLARK COUNTY REHABILITATION AND LIVING CENTER, W4266 STATE HWY 29, OWEN, WI 544602
01/01/2018 12/31/2019GRANTON SCHOOL DISTRICT, 217 N. MAIN STREET, GRANTON, WI 544363
01/01/2018 12/31/2019GREENWOOD ELEMENTARY, 700 EAST DIVISION STREET, GREENWOOD, WI 544373
01/01/2018 12/31/2019GREENWOOD MIDDLE/HIGH SCHOOL, 306 WEST CENTRAL AVENUE, GREENWOOD, WI 544373
01/01/2018 12/31/2019LOYAL SCHOOL DISTRICT, 514 WEST CENTRAL STREET, LOYAL, WI 544463
01/01/2018 12/31/2019NEILLSVILLE ELEMENTARY SCHOOL, 504 EAST 5TH STREET, NEILLSVILLE, WI 544563
01/01/2018 12/31/2019NEILLSVILLE MIDDLE/HIGH SCHOOL, 401 CENTER STREET, NEILLSVILLE, WI 544563
01/01/2018 12/31/2019OWEN-WITHEE SHOOL DISTRICT, 832 WEST 3RD STREET, OWEN, WI 544603
01/01/2018 12/31/2019SCHOOL DISTRICT OF THORP, 605 SOUTH CLARK STREET, THORP, WI 547713
3093CLARK COUNTY COMMUNITY SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/2015
(715) 743-5209
(715) [email protected] VOIGT
County: ClarkNEILLSVILLE, WI 54456517 COURT STREET, ROOM 503
CCS Affiliaton: 09/01/2015Begin: End: Lead:CCS of Clark and Trempealeau Counties
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
1202CLARK COUNTY COMMUNITY SUPPORT PROGRAM
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201704/01/1991
(715) 743-5209
(715) [email protected] GIRARD
County: ClarkNEILLSVILLE, WI 54456517 COURT ST, ROOM 503
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 12/01/2017 11/30/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
COLUMBIAPORTAGE
1066ASPEN FAMILY COUNSELING
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/01/2015
(608) 742-3641
(608) [email protected] ERATH
County: ColumbiaPORTAGE, WI 539012639 NEW PINERY ROAD, #1
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2017 12/31/2018ASPEN FAMILY COUNSELING, 120 3RD STREET, BARABOO, WI 539131
Setting Begin/End DatesNon-Certified School Setting(s)01/01/2017 12/31/2018BARABOO HIGH SCHOOL, 120 DRAPER ST, BARABOO, WI 53913
01/01/2017 12/31/2018CAMBRIA FRIELAND SCHOOL, 410 E EDGEWATER ST, CAMBRIA, WI 53923
01/01/2017 12/31/2018PARDEEVILLE MIDDLE AND HIGH SCHOOL, 120 OAK ST, PARDEEVILLE, WI 53954
01/01/2017 12/31/2018POYNETTE SCHOOLS, 108 N CLEVELAND ST, POYNETTE, WI 53955
01/01/2017 12/31/2018WESTFIELD ELEMENTARY, 329 HAWK LANE, WESTFIELD, WI 53964
2898COLUMBIA COUNTY COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/01/2010
(608) 742-9700
(608) [email protected] WOODARD
County: ColumbiaPORTAGE, WI 539012652 MURPHY ROAD
CCS Affiliaton: 07/01/2014Begin: End: Lead:Wisconsin River CCS Collaboration
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
2149COMMUNITY SERVICES ASSOCIATES DBA PAUQUETTE CTR FOR PSYCHOLOGICAL SVCS
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201810/08/1999
(608) 742-4087
(608) [email protected] SKIBICKY
County: ColumbiaPORTAGE, WI 539012901 HUNTERS TRAIL
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020COMMUNITY SERV ASSOC DBA PAUQUETTE CTR, 1002 LINCOLN AVE, BARABOO, WI 539132
07/01/2018 06/30/2020COMMUNITY SERV ASSOC DBA PAUQUETTE CTR, 1343 PARK AVE, COLUMBUS, WI 539252
07/01/2018 06/30/2020COMMUNITY SERV ASSOC DBA PAUQUETTE CTR, 23295 US HIGHWAY 14 WEST, RICHLAND CENTER, WI 53581
2
07/01/2018 06/30/2020COMMUNITY SERV ASSOC DBA PAUQUETTE CTR, 50 PRAIRIE AVE, PRAIRIE DU SAC, WI 535782
07/01/2018 06/30/2020COMMUNITY SERV ASSOC DBA PAUQUETTE CTR, 710 NORTH WEBB AVE STE 400, REEDSBURG, WI 53959
2
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Substance Abuse Program Directory By County, City, and Provider Name
3159JOURNEY MENTAL HEALTH CENTER CSP - COLUMBIA CO
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/31/2016
(608) 280-2707
(608) 280-3166dawn.anderson-mueller@journeymhDAWN ANDERSON-MUELLER
County: ColumbiaPORTAGE, WI 53901322 DE WITT STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 11/01/2017 10/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2915TRANSITIONS BEHAVIORAL HEALTH LLC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/01/2010
(608) 745-1757
(608) [email protected] BECKETT
County: ColumbiaPORTAGE, WI 53901317 DE WITT ST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 19 of 172
Substance Abuse Program Directory By County, City, and Provider Name
CRAWFORDPRAIRIE DU CHIEN
2376CRAWFORD COUNTY COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201805/01/2002
(608) 326-4395
(608) [email protected] MCWILLIAMS
County: CrawfordPRAIRIE DU CHIEN, WI 53821225 N BEAUMONT ROAD #326
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
1369MAYO CLINIC HEALTH SYSTEM FRANCISCAN MEDICAL CENTER INC. PRAIRIE DU CHIEN
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201701/01/1987
(608) 326-8638
(608) [email protected] ANTHONY
County: CrawfordPRAIRIE DU CHIEN, WI 53821800 E BLACKHAWK AVENUE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 04/01/2017 03/31/2019
CSAS-PREVENTION DHS 75.04 04/01/2017 01/31/2018
Services
NO BRANCH LOCATIONS
06/26/2018 Page 20 of 172
Substance Abuse Program Directory By County, City, and Provider Name
DANEMADISON
3034ARC - MATERNAL AND INFANT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201708/01/2014
(608) 223-9107
(608) [email protected] VAN TOL
County: DaneMADISON, WI 537164202 MONONA DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 08/01/2017 07/31/2018
Services
NO BRANCH LOCATIONS
1053ARC COMMUNITY SERVICES INC MADISON
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/1995
(608) 283-6374
(608) [email protected] FABICK
County: DaneMADISON, WI 537131409 EMIL STREET #100
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
3120ARC DAYTON
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201804/01/201704/01/2016
(608) 241-8073
(608) [email protected] RYAN
County: DaneMADISON, WI 537042009 E DAYTON ST
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/01/2017 03/31/2018
Services
NO BRANCH LOCATIONS
1054ARC HOUSE
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201712/01/1990
(608) 283-6432
(608) [email protected] MILLER
County: DaneMADISON, WI 53703202 N. PATERSON STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
1076ATTIC CORRECTIONAL SERVICES, INC. ACS CLINICAL SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201703/25/2010
(608) 255-4005
(608) [email protected] WALKER
County: DaneMADISON, WI 537131709 S PARK STREET SUITE 1
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 21 of 172
Substance Abuse Program Directory By County, City, and Provider Name
2407CONNECTIONS COUNSELING
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201701/01/2003
(608) 233-2101
(608) 233-2100shelly.dutch@connectionscounselinSHELLY DUTCH
County: DaneMADISON, WI 537055005 UNIVERSITY AVE SUITE #100
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 03/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2017 03/31/2019CONNECTIONS COUNSELING, 660 WEST WASHINGTON AVE SUITE 308, MADISON, WI 537032
3036DANE COUNTY HUMAN SERVICES CCS
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/01/2015
(608) 242-6531
(608) [email protected] MEISTER
County: DaneMADISON, WI 537041202 NORTHPORT DRIVE
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL POPULATION-BASED DHS 36 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
1327FAMILY SERVICE MADISON, INC.
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201704/01/1977
(608) 252-1333
(608) [email protected] SCHOFF
County: DaneMADISON, WI 53713128 E. OLIN AVENUE, #100
Service Begin/End DatesAdm Code
CSAS-PREVENTION DHS 75.04 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 1 DHS 40.11(2)(A) 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
1774HOPE HAVEN-REBOS UNITED, INC - CHRIS FARLEY HOUSE
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201610/01/1993
(608) 255-0340
(608) [email protected] COLLINS
County: DaneMADISON, WI 53715810 W. OLIN AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2016 11/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2986JESSIE CRAWFORD RECOVERY CENTER, INC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201611/02/2012
(608) 467-9135
(608) [email protected] CRAWFORD
County: DaneMADISON, WI 537042101 N SHERMAN AVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 11/01/2016 10/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
1596JOURNEY MENTAL HEALTH CENTER
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/202003/01/201810/01/1975
(608) 280-2707
(608) [email protected] LETTMAN SHUE
County: DaneMADISON, WI 5371149 KESSEL COURT
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/28/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 03/01/2018 02/28/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/28/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 03/01/2018 02/28/2020
Services
NO BRANCH LOCATIONS
1598JOURNEY MENTAL HEALTH CENTER - FORWARD SOLUTIONS CSP
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201609/01/1990
(608) 280-3185
(608) [email protected] ALBERTSON
County: DaneMADISON, WI 537141320 MENDOTA ST SUITE 120
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 06/01/2018 10/31/2018
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
1599JOURNEY MENTAL HEALTH CENTER GATEWAY COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201906/26/201709/01/1990
(608) 280-3160
(608) [email protected] KLEIN
County: DaneMADISON, WI 53713208 E OLIN AVE STE 205
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 06/26/2017 01/31/2019
Services
NO BRANCH LOCATIONS
1593JOURNEY MENTAL HEALTH CENTER-COMMUNITY TREATMENT ALTERNATIVES CSP
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201802/01/1992
(608) 280-2775
(608) [email protected] DELAP
County: DaneMADISON, WI 537042000 FORDEM AVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
06/26/2018 Page 23 of 172
Substance Abuse Program Directory By County, City, and Provider Name
1013MERITER HOSPITAL BEHAVIORAL SERVICES PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201601/01/1984
(608) 417-5334
(608) [email protected] JANTY
County: DaneMADISON, WI 53715202 S. PARK STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 12/01/2016 11/30/2018
MENTAL HEALTH-INPATIENT DHS 61.71 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1617MERITER NEWSTART OUTPATIENT CLINIC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201601/01/1988
(608) 271-3457
(608) [email protected] BORMANN
County: DaneMADISON, WI 537191015 GAMMON LANE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1549MILWAUKEE HEALTH SERVICES SYSTEM, LLC DBA MADISON EAST COMPREHENSIVE TREATMENT C
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201601/01/1994
(608) 242-1166
(608) [email protected] RAGLAND
County: DaneMADISON, WI 537185109 WORLD DAIRY DRIVE
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
1674NORTH BAY LODGE
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201602/01/1984
(608) 242-0021
(608) [email protected] HENDRICKS
County: DaneMADISON, WI 537043602 MEMORIAL DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2016 11/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1750PROGRAM FOR ASSERTIVE COMMUNITY TREATMENT (PACT)
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201709/01/1989
(608) 266-3638
(608) [email protected] LANE FREY
County: DaneMADISON, WI 53703600 WILLIAMSON STREET, #A-B
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 24 of 172
Substance Abuse Program Directory By County, City, and Provider Name
3165PSYCHOLOGICAL ADDICTION SERVICES LLC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/05/201812/05/201711/27/2017
(608) 416-5777
(608) [email protected] ZUKOWSKI
County: DaneMADISON, WI 537043113 E WASHINGTON AVE
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 12/05/2017 12/05/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/05/2017 12/05/2018
Services
NO BRANCH LOCATIONS
2595QUALITY ADDICTION MANAGEMENT, INC DBA MADISON WEST COMPREHENSIVE TREATMENT CTR
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201607/11/2005
(608) 250-2516
(608) [email protected] OKETCH
County: DaneMADISON, WI 53713151 E BADGER ROAD #A
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
2920ROGERS MEMORIAL HOSPITAL - MADISON PARTIAL HOSPITALIZATION PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/13/2010
(608) 238-4412
(608) [email protected] SCHULTZ
County: DaneMADISON, WI 53711406 SCIENCE DRIVE RM #110 & 200
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 11/01/2017 10/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 11/01/2017 10/31/2019
MENTAL HEALTH-DAY TREATMENT WITH TELEHEALTH DHS 61.75 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
1904TELLURIAN, INC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201704/01/1985
(608) 223-3304
(608) [email protected] CROOKS
County: DaneMADISON, WI 537132914 INDUSTRIAL DRIVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 11/01/2017 10/31/2019
CSAS-MEDICALLY MONITORED RESIDENTIAL DETOX DHS 75.07 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 25 of 172
Substance Abuse Program Directory By County, City, and Provider Name
1147THE CENTER FOR CHRISTIAN COUNSELING, CONSULTATION, AND TRAINING INC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201803/01/1982
(608) 274-8783
(608) [email protected] RANDALL
County: DaneMADISON, WI 537185310 WALL STREET, #500
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020THE CTR CHRISTIAN CNSLNG CONS, 208 E MILWAUKEE AVENUE, FORT ATKINSON, WI 535381
1919THE PSYCHOLOGY CLINIC, INC.
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201610/01/1991
(608) 238-1929
(608) [email protected] BLACK, PHD
County: DaneMADISON, WI 53705310 N MIDVALE BOULEVARD #202
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2016 10/31/2018THE PSYCHOLOGY CLINIC, INC - WI DELLS, 1000 HWY 13, WISCONSIN DELLS, WI 539651
11/01/2016 10/31/2018THE PSYCHOLOGY CLINIC, INC - BARABOO, 701 ASH STREET, BARABOO, WI 539132
11/01/2016 10/31/2018THE PSYCHOLOGY CLINIC, INC - PRAIRIE DU SAC, 1190 PRAIRIE STREET, PRAIRIE DU SAC, WI 53578
2
11/01/2016 10/31/2018SAUK PRAIRIE HIGH SCHOOL, 105 NINTH STREET, PRAIRIE DU SAC, WI 535783
1940UNIVERSITY OF WI HOSPITALS & CLINICS
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201811/01/1990
(608) 263-9045
(608) [email protected] GREEN
County: DaneMADISON, WI 53713122 E. OLIN AVENUE, #275
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
1374UW HEALTH BEHAVIORAL HEALTH & RECOVERY
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201601/01/1992
(608) 287-5992
(608) [email protected] WAUPOOSE
County: DaneMADISON, WI 537151102 SOUTH PARK ST SUITE #400
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
06/26/2018 Page 26 of 172
Substance Abuse Program Directory By County, City, and Provider Name
MONONA
1901TELLURIAN OUTPATIENT CLINIC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201704/27/2011
(608) 222-5904
(608) [email protected] CROOKS
County: DaneMONONA, WI 53716300 FEMRITE DR - 2ND FLOOR
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
1900TELLURIAN, INC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201806/01/1993
(608) 663-6694
(608) [email protected] CROOKS
County: DaneMONONA, WI 53716300 FEMRITE DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
STOUGHTON
2675OCEANHAWK COUNSELING ALTERNATIVES, LLC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/17/2006
(877) 674-2177
(608) [email protected] DAUTE
County: DaneSTOUGHTON, WI 53589135 W MAIN STREET, #207A
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
1884STOUGHTON HOSPITAL
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/01/1997
(608) 873-2339
(608) [email protected] KLEINBROOK
County: DaneSTOUGHTON, WI 53589900 RIDGE STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 09/01/2017 08/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SUN PRAIRIE
1742PRAIRIE COUNSELING SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201607/01/1978
(608) 825-4933
(608) [email protected] HUBBARD
County: DaneSUN PRAIRIE, WI 535901460 W. MAIN STREET #6
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
06/26/2018 Page 28 of 172
Substance Abuse Program Directory By County, City, and Provider Name
DODGEBEAVER DAM
1018AFFILIATED COUNSELING CENTER, LLC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201711/01/1989
(920) 887-3977
(920) [email protected] SCHWEFEL-MASSIE
County: DodgeBEAVER DAM, WI 53916108 N LINCOLN AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2017 09/30/2019AFFILIATED COUNSELING CENTER, LLC, 17 FOREST AVENUE, FOND DU LAC, WI 549351
1753AGNESIAN HEALTHCARE D B A PSYCHIATRIC ASSOCIATES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201808/01/201610/01/1984
(920) 885-2788
(920) [email protected] KARTHEISER
County: DodgeBEAVER DAM, WI 53916200 FRONT STREET #3D
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 06/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 06/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 06/30/2018WAYLAND ACACDEMY COUNSELING SERVICES - SCHOEN, 101 NORTH UNIVERSITY AVE, BEAVER
DAM, WI 539163
3106CHURCH HEALTH SERVICES, INC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/17/2015
(920) 887-2322
(920) [email protected] KEMPFER
County: DodgeBEAVER DAM, WI 53916115 N CENTER STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2017 10/31/2019CHURCH HEALTH SERVICES, 15 S. WALNUT STREET, MAYVILLE, WI 530501
Setting Begin/End DatesNon-Certified School Setting(s)11/01/2017 10/31/2019BEAVER DAM HIGH SCHOOL, 500 GOULD ST, BEAVER DAM, WI 53916
11/01/2017 10/31/2019BEAVER DAM MIDDLE SCHOOL, 108 FOURTH STREET, BEAVER DAM, WI 53916
11/01/2017 10/31/2019BEAVER DAM USD ADMIN BLDG, 705 MCKINLEY STREET, BEAVER DAM, WI 53916
11/01/2017 10/31/2019DON SMITH LEARNING ACADEMY, 400 E BURNETT STREET, BEAVER DAM, WI 53916
11/01/2017 10/31/2019JEFFERSON ELEMENTARY, 301 BROOK ST, BEAVER DAM, WI 53916
11/01/2017 10/31/2019LINCOLN ELEMENTARY, 210 GOULD ST, BEAVER DAM, WI 53916
11/01/2017 10/31/2019PRAIRIE VIEW ELEMTARY, 510 N CRYSTAL LAKE ROAD, BEAVER DAM, WI 53916
11/01/2017 10/31/2019SO BEAVER DAM ELEMENTARY, W9787 COUNTY ROAD D, BEAVER DAM, WI 53916
11/01/2017 10/31/2019WASHINGTON ELEMENTARY, 600 GROVE STREET, BEAVER DAM, WI 53916
11/01/2017 10/31/2019WILSON ELEMENTARY, 405 W 3RD STREET, BEAVER DAM, WI 53916
06/26/2018 Page 29 of 172
Substance Abuse Program Directory By County, City, and Provider Name
JUNEAU
2764DODGE COUNTY HUMAN SERVICES & HEALTH DEPT COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201712/11/2007
(920) 386-3812
(920) [email protected] SCHULTZ
County: DodgeJUNEAU, WI 53039199 COUNTY RD DF
CCS Affiliaton: 01/01/2015Begin: End: Lead:Lakeshore Recovery Collaborative
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
1282DODGE COUNTY HUMAN SERVICES AND HEALTH DEPARTMENT
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201710/01/1975
(920) 386-3812
(920) [email protected] SCHULTZ
County: DodgeJUNEAU, WI 53039199 COUNTY RD DF
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2017 02/28/2019
CSAS-EMERGENCY OUTPATIENT DHS 75.05 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 03/01/2017 02/28/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2017 02/28/2019LOMIRA SCHOOL, 1030 4TH ST., LOMIRA, WI 530483
03/01/2017 02/28/2019MAYVILLE HIGH SCHOOL, 500 N. CLARK ST., MAYVILLE, WI 530503
03/01/2017 02/28/2019MAYVILLE MIDDLE SCHOOL, 445 N. HENNINGER ST. RM 3013, MAYVILLE, WI 530503
03/01/2017 02/28/2019ROCK RIVER INTERMEDIATE SCHOOL, 451 E. SPRING ST. RM 153 B, WAUPUN, WI 539633
03/01/2017 02/28/2019VAN BRUNT ELEMENTARY, 611 MILL ST. RM 447, HORICON, WI 530323
2100DODGE COUNTY HUMAN SERVICES AND HEALTH DEPARTMENT CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201701/01/1999
(920) 386-3812
(920) [email protected] SCHULTZ
County: DodgeJUNEAU, WI 53039199 COUNTY ROAD DF
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 30 of 172
Substance Abuse Program Directory By County, City, and Provider Name
WATERTOWN
1278WATERTOWN PHYSICIAN PRACTICES, LLC DBA WRMC DIRECTIONS COUNSELING CENTER
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201811/01/1981
(920) 262-4813
(920) [email protected] NOVOTNY
County: DodgeWATERTOWN, WI 53098123 HOSPITAL DRIVE SUITE 110
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019WRMC CENTER FOR WOMEN'S HEALTH, 128 HOSPITAL DRIVE, WATERTOWN, WI 530981
01/01/2018 12/31/2019WRMC DOCTOR'S COURT CLINIC, 1507 DOCTOR'S COURT, WATERTOWN, WI 530941
01/01/2018 12/31/2019WRMC JOHNSON CREEK CLINIC, 540J VILLAGE WALK LANE, JOHNSON CREEK, WI 530381
01/01/2018 12/31/2019WRMC JUNEAU CLINIC, 334 S WESTERN AVENUE, JUNEAU, WI 530391
01/01/2018 12/31/2019WRMC LAKE MILLS CLINIC, 1025 MULBERRY STREET, LAKE MILLS, WI 535511
06/26/2018 Page 31 of 172
Substance Abuse Program Directory By County, City, and Provider Name
DOORSTURGEON BAY
1250COUNSELING ASSOCIATES OF DOOR COUNTY LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201611/16/1993
(920) 743-1591
(920) [email protected] G NICK
County: DoorSTURGEON BAY, WI 54235620 N 12TH AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2016 11/30/2018COUNSELING ASSOCIATES OF DOOR COUNTY -GB, 330 SOUTH BROADWAY, GREEN BAY, WI 543031
1283DOOR COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201601/01/1978
(920) 746-2439
(920) [email protected] MCFARLANE
County: DoorSTURGEON BAY, WI 54235421 NEBRASKA STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 03/14/2017 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 03/14/2017 09/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 10/01/2016 09/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 03/14/2017 09/30/2018
Services
NO BRANCH LOCATIONS
2159DOOR COUNTY DEPARTMENT OF HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201710/01/1999
(920) 746-2439
(920) [email protected] FLORES
County: DoorSTURGEON BAY, WI 54235421 NEBRASKA STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
3057DOOR COUNTY DEPT OF HUMAN SERVICES - CCS
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/2014
(920) 746-2439
(920) [email protected] MCFARLANE
County: DoorSTURGEON BAY, WI 54235421 NEBRASKA STREET
CCS Affiliaton: 12/01/2014Begin: End: Lead:Lakeshore Recovery Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
DOUGLASSUPERIOR
2847DOUGLAS COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/06/2009
(715) 395-1265
(715) [email protected] LONGSDORF
County: DouglasSUPERIOR, WI 548801316 N 14TH STREET SUITE 400
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
2312HUMAN DEVELOPMENT CENTER MENTAL HEALTH CENTER COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201812/01/1982
(715) 392-6055
(715) [email protected] ENGLESON
County: DouglasSUPERIOR, WI 548801500 N 34TH ST #100
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
3195LAKE SUPERIOR COMMUNITY HEALTH CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/05/201802/05/2018
(218) 722-6939
(218) [email protected] PATTERSON
County: DouglasSUPERIOR, WI 548803600 TOWER AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/05/2018 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/05/2018 01/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier02/05/2018 01/31/2019LSCHC OP MH/AODA OFFICE, 1500 N 34TH STREET #200, SUPERIOR, WI 548802
1926RIDGEWOOD RECOVERY, INC. DBA THE SUPERIOR TREATMENT CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201702/01/1997
(715) 392-8041
(715) [email protected] FETSCH
County: DouglasSUPERIOR, WI 548801810 BELKNAP STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
DUNNMENOMONIE
1050ARBOR PLACE, INC.
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201712/01/1993
(715) 235-4535
(715) [email protected] GAMEZ
County: DunnMENOMONIE, WI 547514076 KOTHLOW AVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 10/01/2017 09/30/2019
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 10/01/2017 09/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
CSAS-PREVENTION DHS 75.04 10/01/2017 09/30/2019
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 10/01/2017 09/30/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
2055DUNN COUNTY DEPARTMENT OF HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201706/01/1998
(715) 232-5987
(715) [email protected] WINGER
County: DunnMENOMONIE, WI 547513001 US HWY 12 EAST, SUITE 160
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 06/01/2017 05/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
EAU CLAIREALTOONA
1348FIRST THINGS FIRST COUNSELING & CONSULTING
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201709/01/1990
(715) 832-5007
(715) [email protected] DRAKE
County: Eau ClaireALTOONA, WI 547202519 N HILLCREST PKWY STE 103
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2018
Services
NO BRANCH LOCATIONS
EAU CLAIRE
1020AFFINITY HOUSE
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/202003/01/201803/01/1992
(715) 833-1505
(715) [email protected] KUSTER
County: Eau ClaireEAU CLAIRE, WI 547033042 KILBOURNE AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 03/01/2018 02/28/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 03/01/2018 02/28/2020
Services
NO BRANCH LOCATIONS
1119CAILLIER CLINIC, LTD.
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201601/01/1983
(715) 836-0065
(715) [email protected] CAILLIER
County: Eau ClaireEAU CLAIRE, WI 547012620 STEIN BLVD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2016 11/30/2018CAILLIER CLINIC LTD., 700 WOLSKE BAY RD, STE 210, MENOMONIE, WI 547511
12/01/2016 11/30/2018CAILLIER CLINIC, LTD, 138 N. MAIN ST SUITE 206, RICE LAKE, WI 548682
1292EAU CLAIRE ACADEMY, DIVISION OF CLINICARE CORPORATION
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201702/01/1994
(715) 834-9954
(715) [email protected] MATTER
County: Eau ClaireEAU CLAIRE, WI 54703550 N. DEWEY STREET
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 09/01/2017 08/31/2019
CSAS-TRANSITIONAL RESIDENTIAL WITH TELEHEALTH HFS 75.14 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3112EAU CLAIRE COUNTY DEPARTMENT OF HUMAN SERVICES - CCS PROGRAM
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201804/01/2016
(715) 831-5784
(715) [email protected] STEIN
County: Eau ClaireEAU CLAIRE, WI 54703721 OXFORD AVENUE
CCS Affiliaton: 04/01/2016Begin: End: Lead:Eau Claire and St. Croix CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2018 03/31/2019
Services
NO BRANCH LOCATIONS
1293EAU CLAIRE COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/202003/01/201801/01/1990
(715) 831-5783
(715) [email protected] HON
County: Eau ClaireEAU CLAIRE, WI 54703721 OXFORD AVENUE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 03/01/2018 02/28/2020
Services
NO BRANCH LOCATIONS
2537EAU CLAIRE METRO TREATMENT CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201708/16/2004
(715) 834-1218
(715) [email protected] BAKER
County: Eau ClaireEAU CLAIRE, WI 547032000 OXFORD AVE NORTH BLDG 2
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 06/01/2017 05/31/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2017 05/31/2020
Services
NO BRANCH LOCATIONS
3083GATEWAY COUNSELING, LLC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201802/01/201602/09/2015
(715) [email protected] BRAHAN
County: Eau ClaireEAU CLAIRE, WI 547013459 LONDON ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2016 01/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2993GREAT LAKES BEHAVIORAL HEALTH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201703/01/2013
(715) 834-4427
(715) [email protected] MATTER
County: Eau ClaireEAU CLAIRE, WI 54703550 NORTH DEWEY STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2017 08/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2019MILWAUKEE ACADEMY, 9501 WATERTOWN PLANK ROAD, WAUWATOSA, WI 532131
1529LUTHERAN SOCIAL SERVICES-FAHRMAN CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201811/01/1986
(715) 830-4098
(715) [email protected] SWEENEY
County: Eau ClaireEAU CLAIRE, WI 547013136 CRAIG ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 07/01/2018 06/30/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
1511MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE HOSPITAL, INC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201606/01/1981
(715) 838-3649
(715) [email protected] PHILLIPS
County: Eau ClaireEAU CLAIRE, WI 547011221 WHIPPLE STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 12/01/2016 11/30/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 04/25/2017 11/30/2018
MENTAL HEALTH-INPATIENT DHS 61.71 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1512MAYO CLINIC HEALTH SYSTEM EAU CLAIRE
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201710/01/1981
(715) 838-3032
(715) [email protected] MING
County: Eau ClaireEAU CLAIRE, WI 547021221 WHIPPLE STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 01/01/2017 12/31/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 01/27/2018 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2017 12/31/2018MAYO CLINIC HEALTH SYSTEMS - CHIPPEWA FALLS OFFICE, 611 1ST AVENUE, CHIPPEWA FALLS,
WI 547291
01/01/2017 12/31/2018MAYO CLINIC HEALTH SYSTEM NORTHLAND, 331 S MAIN STREET, RICE LAKE, WI 548682
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Substance Abuse Program Directory By County, City, and Provider Name
3114NORTH WEST WISCONSIN COMPREHENSIVE TREATMENT CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201903/01/201702/29/2016
(760) 930-8923
(855) [email protected] JOHNSON
County: Eau ClaireEAU CLAIRE, WI 547013440 OAKWOOD HILLS PKWY
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2017 10/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2947SACRED HEART BEHAVIORAL HEALTH CLINIC DBA PREVEA HEALTH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201808/29/201610/31/2011
(715) 717-5898
(715) [email protected] SIMONSON
County: Eau ClaireEAU CLAIRE, WI 547012119 HEIGHTS DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/29/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/29/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 08/29/2016 12/31/2016
Services
NO BRANCH LOCATIONS
1408SYNERGY GROUP OF EAU CLAIRE, SC DBA VANTAGE POINT CLINIC & ASSESSMENT CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201608/01/1990
(715) 834-3174
(715) [email protected] BJERKE
County: Eau ClaireEAU CLAIRE, WI 547012005 HIGHLAND AVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018SYNERGY GROUP EAU CLAIRE DBA VANTAGE POINT CLINIC, 1443 B EAST DIVISION AVE, BARRON,
WI 548122
09/01/2016 08/31/2018SYNERGY GROUP EAU CLAIRE DBA VANTAGE POINT CLINIC, 420 S BARSTOW STREET, #3, EAU CLAIRE, WI 54701
2
1936TRINITEAM, INC.
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201810/01/201703/01/1989
(715) 836-8104
(715) [email protected] PEITZMAN
County: Eau ClaireEAU CLAIRE, WI 54701202 GRAHAM AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 03/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2017 03/31/2018BUFFALO CO COURTHOUSE- DHS TRINITEAM, 407 SOUTH SECOND ST, ALMA, WI 546101
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Substance Abuse Program Directory By County, City, and Provider Name
FOND DU LACEDEN
3144MAHALA'S HOPE
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/12/2016
(920) 477-3777
(920) [email protected] HARDIE
County: Fond Du LacEDEN, WI 53019N4590 HWY 45
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
FOND DU LAC
3121ARC FOND DU LAC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201706/01/2016
(920) 907-0681
(920) [email protected] RHOADS
County: Fond Du LacFOND DU LAC, WI 5493527 EAST 3RD ST #208
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 06/01/2017 05/31/2019
Services
NO BRANCH LOCATIONS
1085BEACON HOUSE
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201805/28/1993
(920) 923-3240
(920) [email protected] GERLACH
County: Fond Du LacFOND DU LAC, WI 54936166 SOUTH PARK AVENUE
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
1108BLANDINE HOUSE, INC.
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/08/1991
(920) 922-9184
(920) [email protected] MIER SR.
County: Fond Du LacFOND DU LAC, WI 5493525 N. PARK AVENUE
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2680FOND DU LAC COUNTY DEPARTMENT OF COMMUNITY PROGRAMS CCS
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201901/01/201807/18/2006
(920) 929-3129
(920) 929-7123heather [email protected] FOUST
County: Fond Du LacFOND DU LAC, WI 54935459 E FIRST STREET
CCS Affiliaton: 01/01/2018Begin: End: Lead:Northeastern Regional CCS Consortium V2
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 01/01/2018 07/31/2019
Services
NO BRANCH LOCATIONS
1350FOND DU LAC COUNTY DEPT OF COMMUNITY PROGRAMS
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201807/01/1978
(920) 929-3129
(920) [email protected] VANEVENHOVEN
County: Fond Du LacFOND DU LAC, WI 54935459 E FIRST STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 03/01/2018 02/29/2020
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
CSAS-PREVENTION DHS 75.04 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 03/01/2018 02/29/2020
MENTAL HEALTH-INPATIENT DHS 61.71 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
3075PREMIER CARE OF WISCONSIN LLC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201605/05/2015
(800) 377-9518
(920) [email protected] ROGERS
County: Fond Du LacFOND DU LAC, WI 5493523 WEST SCOTT ST
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 05/01/2016 04/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2016 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1847ST. AGNES HOSPITAL BEHAVIORAL HEALTH SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201805/01/1980
(920) 926-8933
(920) [email protected] KARTHEISER
County: Fond Du LacFOND DU LAC, WI 54935430 EAST DIVISION STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/01/2018 12/31/2019
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 01/01/2018 12/31/2019
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 01/01/2018 12/31/2019
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 01/01/2018 12/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 01/01/2018 12/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019ST AGNES HOSPITAL BEHAVIORAL HEALTH SVS, 608 W BROWN ST, WAUPUN, WI 539631
01/01/2018 12/31/2019AGNESIAN AT MARR, 21 S MARR STREET, FOND DU LAC, WI 549352
01/01/2018 12/31/2019ST AGNES HOSPITAL BEHAVIORAL HEALTH, 845 PARKSIDE, RIPON, WI 549712
01/01/2018 12/31/2019WAUPUN MEM HOSP BEHAVIORAL HEALTH, 620 W BROWN ST, WAUPUN, WI 539632
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Substance Abuse Program Directory By County, City, and Provider Name
FORESTCRANDON
1351FOREST COUNTY POTAWATOMI BEHAVIORAL HEALTH DEPARTMENT
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/01/1994
(715) 478-4493
(715) [email protected] NICKEY
County: ForestCRANDON, WI 545208201 MISH KO SWEN DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 04/01/2018 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
GRANTLANCASTER
1943UNIFIED COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201710/01/1975
(608) 723-4417
(608) [email protected] KNAPP
County: GrantLANCASTER, WI 53813200 W ALONA LANE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 07/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
CSAS-PREVENTION DHS 75.04 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
1941UNIFIED COMMUNITY SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201607/01/1994
(608) 723-4417
(608) [email protected] KNAPP
County: GrantLANCASTER, WI 53813200 W. ALONA LANE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 10/01/2016 09/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2016 09/30/2018UNIFIED COMMUNITY SERVICES - CSP, 1122 PROFESSIONAL DRIVE, DODGEVILLE, WI 535331
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Substance Abuse Program Directory By County, City, and Provider Name
GREENMONROE
1388GREEN COUNTY HUMAN SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201810/01/1975
(608) 328-9480
(608) [email protected] HOLCOMB
County: GreenMONROE, WI 53566N3152 STATE ROAD 81
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 01/01/2018 12/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
CSAS-PREVENTION DHS 75.04 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019GREEN COUNTY ADULT DRUG COURT, 2841 6TH STREET, MONROE, WI 535662
2328GREEN COUNTY HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/2000
(608) 328-9480
(608) [email protected] HOLCOMB
County: GreenMONROE, WI 53566N 3152 STATE ROAD 81
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
3085GREEN/LAFAYETTE REGIONAL COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201706/01/2015
(608) 328-9480
(608) [email protected] FARREY
County: GreenMONROE, WI 53566N3152 STATE RD 81
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 06/01/2017 05/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2017 05/31/2019GREEN/LAFAYETTE REGIONAL CCS AT LAFAYETTE CTY HS, 15701 COUNTY ROAD K, DARLINGTON,
WI 535301
06/26/2018 Page 44 of 172
Substance Abuse Program Directory By County, City, and Provider Name
GREEN LAKEGREEN LAKE
1389GREEN LAKE COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201604/01/1977
(920) 294-4139
(920) [email protected] JEROME
County: Green LakeGREEN LAKE, WI 54941571 COUNTY ROAD A
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 11/01/2016 10/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
CSAS-PREVENTION DHS 75.04 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 11/01/2016 10/31/2018
Services
Setting Begin/End DatesNon-Certified School Setting(s)11/01/2016 10/31/2018BERLIN MIDDLE SCHOOL, 242 MEMORIAL DRIVE, BERLIN, WI 54923
2265GREEN LAKE COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/01/2000
(920) 294-4139
(920) [email protected] JEROME
County: Green LakeGREEN LAKE, WI 54941571 COUNTY ROAD A
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2599GREEN LAKE COUNTY DHHS COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201708/22/2005
(920) 294-4139
(920) [email protected] JEROME
County: Green LakeGREEN LAKE, WI 54941571 COUNTY ROAD A
CCS Affiliaton: 09/01/2014 12/31/2015Begin: End: Lead:Central Wisconsin Health Partnership
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 45 of 172
Substance Abuse Program Directory By County, City, and Provider Name
IOWADODGEVILLE
1942UNIFIED COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201710/01/1975
(608) 935-3174
(608) [email protected] KNAPP
County: IowaDODGEVILLE, WI 535331122 PROFESSIONAL DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 46 of 172
Substance Abuse Program Directory By County, City, and Provider Name
IRONHURLEY
2347IRON COUNTY HUMAN SERVICES DEPARTMENT AND ASSOCIATES
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/2002
(715) 561-2128
(715) [email protected] BUCKNELL
County: IronHURLEY, WI 54534300 TACONITE STREET, #201
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 03/01/2017 02/28/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2017 02/28/2019HURLEY SCHOOL DISTRICT, 5503 W RANGE VIEW DR, HURLEY, WI 545343
2745IRON COUNTY HUMAN SERVICES DEPARTMENT AND ASSOCIATES COMM SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/2007
(715) 561-2128
(715) [email protected] BUCKNELL
County: IronHURLEY, WI 54534300 TACONITE STREET, #201
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 03/01/2017 02/28/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
06/26/2018 Page 47 of 172
Substance Abuse Program Directory By County, City, and Provider Name
JACKSONBLACK RIVER FALLS
1413HO-CHUNK NATION DEPARTMENT OF HEALTH DIVISION OF BEHAVIORAL HEALTH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201605/01/1992
(715) 284-3434
(715) [email protected] SUQUET
County: JacksonBLACK RIVER FALLS, WI 54615W9850 AIRPORT RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 04/01/2018 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 04/01/2018 10/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 10/31/2018MADISON BRANCH OFFICE, 4724 TRADE WINDS PARKWAY, MADISON, WI 537181
11/01/2016 10/31/2018NEKOOSA HEALTH OFFICE, 1021 COUNTY HWY G, NEKOOSA, WI 544572
11/01/2016 10/31/2018THREE RIVERS HOUSE, 724 MAIN STREET, LA CROSSE, WI 546012
11/01/2016 10/31/2018TOMAH HEALTH OFFICE, 430 JULIE ST, STE 2, TOMAH, WI 546602
11/01/2016 10/31/2018WELLNESS CENTER HEALTH OFFICE, S2845 WHITE EAGLE ROAD, BARABOO, WI 539132
03/01/2017 10/31/2018WITTENBERG HEALTH OFFICE, W17634 RADKE RD, WITTENBERG, WI 544992
2957JACKSON COUNTY DEPT OF HEALTH & HUMAN SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201601/01/2012
(715) 284-7713
(715) [email protected] ANDRE
County: JacksonBLACK RIVER FALLS, WI 54615420 HIGHWAY 54 WEST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
06/26/2018 Page 48 of 172
Substance Abuse Program Directory By County, City, and Provider Name
JEFFERSONJEFFERSON
1449JEFFERSON COUNTY HUMAN SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201710/01/1975
(920) 674-6113
(920) [email protected] CAULEY
County: JeffersonJEFFERSON, WI 535491541 ANNEX ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2017 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2017 05/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 06/01/2017 05/31/2019
Services
NO BRANCH LOCATIONS
2221JEFFERSON COUNTY HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201806/01/2000
(920) 674-7409
(920) [email protected] THORMAN
County: JeffersonJEFFERSON, WI 535491541 ANNEX ROAD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
2643JEFFERSON COUNTY HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201702/15/2006
(920) 674-2359
(920) [email protected] CONGDON
County: JeffersonJEFFERSON, WI 535491541 ANNEX ROAD
CCS Affiliaton: 08/01/2014Begin: End: Lead:JRW Tri County Regional CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
WATERTOWN
1326FAMILY RESOURCES ASSOCIATES, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201611/01/1993
(920) 261-8801
(920) [email protected] KUEFFER
County: JeffersonWATERTOWN, WI 530941315 W. MAIN STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2016 10/31/2018FAMILY RESOURCES ASSOCIATES INC, 248 S. WISCONSIN DRIVE, JEFFERSON, WI 535492
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Substance Abuse Program Directory By County, City, and Provider Name
JUNEAULYNDON STATION
3173PINE VALLEY INTEGRATED SERVICES LLC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201807/14/2017
(608) 350-1288
(608) [email protected] BRONECKI
County: JuneauLYNDON STATION, WI 53944W1889 KOVAL ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2018 05/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2018 05/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2018 05/31/2020NEW LISBON FAMILY MEDICAL CENTER, 901 BRIDGE ST, NEW LISBON, WI 539501
06/01/2018 05/31/2020MILE BLUFF CLINIC, 1040 DIVISION STREET, MAUSTON, WI 539482
06/01/2018 06/30/2018ADAMS FRIENDSHIP ELEMENTARY SCHOOL, 500 N PIERCE ST, ADAMS, WI 539103
06/01/2018 06/30/2018ADAMS FRIENDSHIP HIGH SCHOOL, 1109 E NORTH ST, ADAMS, WI 539103
06/01/2018 06/30/2018ADAMS FRIENDSHIP MIDDLE SCHOOL, 420 N MAIN ST, ADAMS, WI 539103
MAUSTON
1453JUNEAU COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/1988
(608) 847-9421
(608) [email protected] GEIGER
County: JuneauMAUSTON, WI 53948200 HICKORY STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
3000JUNEAU COUNTY DEPARTMENT OF HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/01/2013
(608) 847-9421
(608) [email protected] GEIGER
County: JuneauMAUSTON, WI 53948220 E LA CROSSE STREET RM #23
CCS Affiliaton: 09/01/2014 12/31/2015Begin: End: Lead:Central Wisconsin Health Partnership
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
1452JUNEAU COUNTY DEPARTMENT OF HUMAN SERVICES-COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201701/01/1989
(608) 847-9576
(608) [email protected] JO ONSAGER
County: JuneauMAUSTON, WI 53948220 E LACROSSE STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
KENOSHABURLINGTON
3185WI AWAKEN INC
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201811/06/201711/06/2017
(844) 247-2735
(262) [email protected] BISHOP
County: KenoshaBURLINGTON, WI 53105101 EDWARD STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/06/2017 11/30/2018
Services
NO BRANCH LOCATIONS
KENOSHA
2443COMPASSIONATE CARE COUNSELING (A DIV OF COMPETITIVE EDGE EMP ASSURANCE SVS)
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201806/01/2003
(262) 605-0809
(262) [email protected] M ORLAKIS
County: KenoshaKENOSHA, WI 531403624 - 17TH AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
2200GENESIS BEHAVIORAL SERVICES OPTIONS RESIDENTIAL PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201803/14/2000
(262) 654-8826
(262) [email protected] SANCHEZ
County: KenoshaKENOSHA, WI 531406755 - 14TH AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/01/2018 03/31/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
1024HOPE COUNCIL ON ALCOHOL & OTHER DRUG ABUSE, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201702/15/1990
(262) 658-8210
(262) [email protected] BROWN
County: KenoshaKENOSHA, WI 531405942 - SIXTH AVENUE
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
1440INTERCONNECTIONS, S.C.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201708/01/1981
(262) 654-7818
(262) [email protected] NICHOLS
County: KenoshaKENOSHA, WI 53140920 - 60TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1014KARE CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201610/10/1987
(262) 653-2080
(262) [email protected] FOSS
County: KenoshaKENOSHA, WI 53140510 - 60TH STREET
Service Begin/End DatesAdm Code
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
2589KENOSHA COUNTY DEPARTMENT OF HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201705/01/2005
(262) 697-4655
(262) [email protected] HANKS
County: KenoshaKENOSHA, WI 531438600 SHERIDAN RD #100
CCS Affiliaton: 12/01/2014Begin: End: Lead:Kenosha Racine Regional Consortium (KRRC)
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 05/01/2017 04/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2017 04/30/2019KENOSHA HUMAN DEVELOPMENT SERVICES, INC (KHDS), 5407 8TH AVENUE, KENOSHA, WI 531402
2897KENOSHA HUMAN DEVELOPMENT SERVICES, INC COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/01/2010
(262) 653-2080
(262) [email protected]; [email protected] A HAEN, MS
County: KenoshaKENOSHA, WI 531405407 8TH AVENUE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
2613MOORE AND ASSOCIATES/BIRDS OF A FEATHER, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201709/14/2005
(262) 605-1404
(262) [email protected] MOORE
County: KenoshaKENOSHA, WI 531436530 SHERIDAN ROAD, #3
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 10/01/2017 09/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2017 09/30/2019MOORE & ASSOCIATES, INC, 220 S COUNTY ROAD H, UNIT A, ELKHORN, WI 531211
10/01/2017 09/30/2019MOORE & ASSOCIATES, INC, 1656 WASHINGTON AVE, RACINE, WI 534042
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Substance Abuse Program Directory By County, City, and Provider Name
2028OAKWOOD CLINICAL ASSOCIATES, LTD.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201802/25/1991
(262) 652-2931
(262) [email protected] ANDERSON
County: KenoshaKENOSHA, WI 531424109 67TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2018 02/29/2020OAKWOOD CLINICAL ASSOCIATES LTD, 24804 75TH STREET, PADDOCK LAKE, WI 531682
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Substance Abuse Program Directory By County, City, and Provider Name
1749PROFESSIONAL SERVICES GROUP, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201806/01/1983
(262) 652-2408
(262) [email protected] FEATHERSTONE
County: KenoshaKENOSHA, WI 531432108 63RD STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020PROFESSIONAL SERVICES GROUP, 614 N 3RD STREET, WAUSAU, WI 544031
04/01/2018 03/31/2020PROFESSIONAL SERVICES GROUP, 724 ELM STREET, WEST BEND, WI 530951
04/01/2018 03/31/2020PROFESSIONAL SERVICES GROUP, 1126 S 70TH STREET, #112-3, WEST ALLIS, WI 532142
04/01/2018 03/31/2020PROFESSIONAL SERVICES GROUP, 2333 NORTHWESTERN AVE, RACINE, WI 534042
Setting Begin/End DatesNon-Certified School Setting(s)04/01/2018 03/31/2020ADDISON ELEMENTARY, 5050 INDIAN ROAD, HARTFORD, WI 53027
04/01/2018 03/31/2020BADGER MIDDLE SCHOOL, 727 S 6TH AVE, WEST BEND, WI 53095
04/01/2018 03/31/2020CENTRAL MIDDLE SCHOOL, 1100 CEDAR ST, HARTFORD, WI 53027
04/01/2018 03/31/2020COUNTY LINE ELEMENTARY, W159 N9939 BUTTERNUT RD, GERMANTOWN, WI 53022
04/01/2018 03/31/2020DECORAH ELEMENTARY, 1225 SULVAN WAY, WEST BEND, WI 53095
04/01/2018 03/31/2020DREAM CENTER, 1190 WESTERN DR, HARTFORD, WI 53027
04/01/2018 03/31/2020FAIRPARK ELEMENTARY SCHOOL, 519 INDIANA AVE, WEST BEND, WI 53095
04/01/2018 03/31/2020GREAT EXPECTATIONS, 735 MAIN ST, WEST BEND, WI 53095
04/01/2018 03/31/2020HEADSTART, 737 S 3RD AVE, WEST BEND, WI 53095
04/01/2018 03/31/2020I4 LEARNING, 5760 MOWHAWK RD, CAMPBELLSPORT, WI 53010
04/01/2018 03/31/2020KENNEDY MIDDLE SCHOOL, W160 N11836 CRUSADER CT, GERMANTOWN, WI 53022
04/01/2018 03/31/2020KEWAKSUM ELEMENTARY, 1415 BILGO LANE, KEWASKUM, WI 53040
04/01/2018 03/31/2020KEWAKSUM MIDDLE SCHOOL, 1676 REIGLE DR, KEWASKUM, WI 53040
04/01/2018 03/31/2020LAKEWOOD ELEMENTARY SCHOOL, 1218 WILMOT AVE, TWIN LAKES, WI 53181
04/01/2018 03/31/2020LINCOLN ELEMENTARY, 755 RURAL ST, HARTFORD, WI 53027
04/01/2018 03/31/2020MACARTHUR ELEMENTARY SCHOOL, N154 W11942 FOND DU LAC AVE, GERMANTOWN, WI 53022
04/01/2018 03/31/2020MCLANE ELEMENTARY, 833 CHESTNUT ST, WEST BEND, WI 53095
04/01/2018 03/31/2020PATHWAYS CHARTER, 1043 S MAIN ST, WEST BEND, WI 53095
04/01/2018 03/31/2020RANDALL CONSOLIDATED SCHOOL, 37101 87TH ST, BURLINGTON, WI 53105
04/01/2018 03/31/2020RIVERVIEW ELEMENTARY SCHOOL, 300 E PROSSER ST, SILVER LAKE, WI 53170
04/01/2018 03/31/2020ROSSMAN ELEMENTARY, 600 HIGHLAND, HARTFORD, WI 53027
04/01/2018 03/31/2020SILVERBROOK INTERMEDIATE, 120 N SILVERBROOK RD, WEST BEND, WI 53095
04/01/2018 03/31/2020SLINGER MIDDLE SCHOOL, 521 OLYMPIC DR, SLINGER, WI 53086
04/01/2018 03/31/2020WEST BEND EAST HIGH SCHOOL, 1305 E DECORAH RD, WEST BEND, WI 53095
04/01/2018 03/31/2020WILMOT UNION HIGH SCHOOL, 11112 308TH AVE, WILMOT, WI 53192
06/26/2018 Page 54 of 172
Substance Abuse Program Directory By County, City, and Provider Name
1752PSYCHIATRIC AND PSYCHOTHERAPY CLINIC
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201806/01/1980
(262) 654-2434
(262) [email protected] DEFAZIO
County: KenoshaKENOSHA, WI 531443601 - 30TH AVENUE, #102
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
2433ROGERS MEMORIAL HOSPITAL CHILD AND ADOLESCENT DAY TREATMENT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201804/28/2003
(262) 942-7740
(262) [email protected] SCHULTZ
County: KenoshaKENOSHA, WI 531429916 - 75TH STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 05/01/2018 04/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH-DAY TREATMENT DHS 61.75 05/01/2018 04/30/2020
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 2 DHS 40.11(2)(B) 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
06/26/2018 Page 55 of 172
Substance Abuse Program Directory By County, City, and Provider Name
KEWAUNEEKEWAUNEE
2288KEWAUNEE COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201702/01/1977
(920) 388-7044
(920) [email protected] BORKOVETZ
County: KewauneeKEWAUNEE, WI 54216810 LINCOLN STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
1466KEWAUNEE COUNTY DEPT OF HUMAN SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201702/01/1977
(920) 388-7044
(920) [email protected] NORTON
County: KewauneeKEWAUNEE, WI 54216810 LINCOLN STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 02/01/2017 01/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2017 01/31/2019
CSAS-PREVENTION DHS 75.04 02/01/2017 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2017 01/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
2781KEWAUNEE COUNTY DHS COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201703/11/2008
(920) 388-7044
(920) [email protected] NORTON
County: KewauneeKEWAUNEE, WI 54216810 LINCOLN STREET
CCS Affiliaton: 12/01/2014Begin: End: Lead:Lakeshore Recovery Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
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LA CROSSELA CROSSE
3006ACS CLINICAL SERVICES, LLC - LA CROSSE
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/01/2013
(608) 784-3384
(608) [email protected] KREGER
County: La CrosseLA CROSSE, WI 546012101 VICTORY STREET
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
1240COULEE COUNCIL ON ADDICTIONS, INC.
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201611/01/1986
(608) 784-6302
(608) [email protected] HANCOCK
County: La CrosseLA CROSSE, WI 54601921 WEST AVENUE SOUTH
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
CSAS-PREVENTION DHS 75.04 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
2802COUNSELING ASSOCIATES LLC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201806/05/2008
(608) 785-0273
(608) [email protected] EINSMAN
County: La CrosseLA CROSSE, WI 54601115 - 5TH AVENUE SOUTH, #301
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2018 05/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2018 05/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2018 05/31/2020COUNSELING ASSOCIATES LLC, 111 MARKET STREET #4A, WINONA, MN 559872
3021DRIFTLESS RECOVERY SERVICES INC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/14/2014
(608) 519-5909
(608) [email protected] REINHART
County: La CrosseLA CROSSE, WI 54601444 MAIN ST SUITE 301
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
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1315FAMILY AND CHILDREN'S CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201702/01/1994
(608) 785-0002
(608) [email protected] SOUTHWORTH
County: La CrosseLA CROSSE, WI 546011707 MAIN STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2017 10/31/2019FAMILY AND CHILDREN'S CENTER, 1321 NORTH MAIN ST, VIROQUA, WI 546651
1391GUNDERSEN CLINIC LIMITED BEHAVIORAL HEALTH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201912/01/201602/01/1984
(608) 775-6055
(608) [email protected] THOMPSON
County: La CrosseLA CROSSE, WI 546011836 SOUTH AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 12/01/2016 01/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2016 01/31/2019GUNDERSEN CLINIC LTD,, 18606 ERVIN STREET, WHITEHALL, WI 547731
12/01/2016 01/31/2019GUNDERSEN CLINIC, LTD, 226 NORTH 2ND STREET, LA CRESCENT, MN 559471
12/01/2016 01/31/2019GUNDERSEN CLINIC, LTD., BEHAVIORAL HEALTH, 110 JEFFERSON STREET, WEST UNION, IA 521751
12/01/2016 01/31/2019GUNDERSON CLINIC LTD, 35791 OSSEO ROAD, INDEPENDENCE, WI 547471
12/01/2016 01/31/2019GUNDERSON CLINIC LTD, 420 SOUTH PETERSON AVE, BLAIR, WI 546161
12/01/2016 01/31/2019RICHLAND MEDICAL CENTER, 301 EAST 2ND STREET, RICHLAND CENTER, WI 535811
12/01/2016 01/31/2019VERNON MEMORIAL HEALTHCARE, 507 SOUTH MAIN ST, VIROQUA, WI 546651
12/01/2016 01/31/2019GUNDERSEN CLINIC LTD, 610 E TAYLOR STREET, PRAIRIE DU CHIEN, WI 538212
12/01/2016 01/31/2019GUNDERSEN CLINIC, LTD, 1830 STATE HWY 9, DECORAH, IA 521012
12/01/2016 01/31/2019GUNDERSEN CLINIC, LTD, 601 N SUPERIOR, TOMAH, WI 546602
01/09/2017 01/31/2019GUNDERSEN CLINIC, LTD., BEHAVIORAL HEALTH, 1111 W WISCONSIN STREET, SPARTA, WI 546562
12/01/2016 01/31/2019GUNDERSEN LUTHERAN MEDICAL CENTER, 123 - 16TH AVE SOUTH, ONALASKA, WI 546502
12/01/2016 01/31/2019GUNDERSEN LUTHERAN MEDICAL CENTER, 3111 GUNDERSEN DRIVE, ONALASKA, WI 546502
05/02/2017 01/31/2019GUNDERSEN VIROQUA CLINIC, 407 SOUTH MAIN STREET, VIROQUA, WI 546652
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Substance Abuse Program Directory By County, City, and Provider Name
1520GUNDERSEN LUTHERAN MEDICAL CENTER, INC. BEHAVIORAL HEALTH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201912/01/201603/01/1982
(608) 775-6055
(608) [email protected] THOMPSON
County: La CrosseLA CROSSE, WI 546011910 SOUTH AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 12/01/2016 01/31/2019
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 12/01/2016 01/31/2019
CSAS-NARCOTIC TREATMENT DHS 75.15 12/01/2016 08/31/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 01/31/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 12/01/2016 01/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 12/01/2016 01/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier02/05/2018 01/31/2019GUNDERSEN HARMONY CLINIC, 805 COUNTY ROAD 44, HARMONY, MN 559391
02/05/2018 01/31/2019GUNDERSEN HOUSTON CLINIC, 511 EAST MAPLE ST, HOUSTON, MN 559431
02/05/2018 01/31/2019GUNDERSEN SPRING GROVE CLINIC, 8123 5TH AVENUE SOUTHEAST, SPRING GROVE, MN 559741
02/05/2018 01/31/2019DAHL FAMILY YMCA, 1140 MAIN ST, LA CROSSE, WI 546012
12/01/2016 01/31/2019GUNDERSEN CLINIC, LTD., BEHAVIORAL HEALTH, 124 NORTH COURT STREET, SPARTA, WI 546562
12/01/2016 01/31/2019GUNDERSEN LUTH MED CTR BEHAV HEALTH, 123 - 16TH AVENUE SOUTH, ONALASKA, WI 546502
12/01/2016 01/31/2019GUNDERSEN LUTH MED CTR BEHAV HEALTH, 18606 ERVIN STREET, WHITEHALL, WI 547732
12/01/2016 01/31/2019GUNDERSEN LUTH MED CTR BEHAV HEALTH, 3111 GUNDERSEN DRIVE, ONALASKA, WI 546502
12/01/2016 01/31/2019GUNDERSEN LUTH MED CTR BEHAV HEALTH, 601 N SUPERIOR AVENUE, TOMAH, WI 546602
12/01/2016 01/31/2019GUNDERSEN LUTH MED CTR BEHAV HEALTH, 610 E TAYLOR STREET, PRAIRIE DU CHIEN, WI 538212
1951GUNDERSEN LUTHERAN MEDICAL CENTER, INC. UNITY HOUSE FOR MEN
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/1993
(608) 775-4791
(608) [email protected] THOMPSON
County: La CrosseLA CROSSE, WI 546011922-1924 MILLER STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2016 11/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
2782GUNDERSEN LUTHERAN MEDICAL CENTER, INC., UNITY HOUSE FOR MEN
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/2008
(608) 775-4791
(608) [email protected] THOMPSON
County: La CrosseLA CROSSE, WI 546011918-1920 MILLER STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2016 11/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
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1952GUNDERSEN LUTHERAN MEDICAL CENTER, INC., UNITY HOUSE FOR WOMEN
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201611/01/1993
(608) 775-4710
(608) [email protected] THOMPSON
County: La CrosseLA CROSSE, WI 546011312 FIFTH AVENUE, SOUTH
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2016 11/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1488LA CROSSE COUNTY HUMAN SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201802/01/1978
(608) 785-6122
(608) [email protected] TRUSSONI
County: La CrosseLA CROSSE, WI 54601300 N 4TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 05/01/2018 04/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2018 04/30/2020LAKEVIEW HEALTH CENTER, 902 GARLAND ST, WEST SALEM, WI 546691
05/01/2018 04/30/2020RAVENWOOD, 902 GARLAND ST. EAST, WEST SALEM, WI 546691
05/01/2018 04/30/2020ROLLING HILLS, 14346 COUNTY HWY B, SPARTA, WI 546561
2935LA CROSSE COUNTY HUMAN SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201801/19/2011
(608) 785-5715
(608) [email protected] SPANJERS
County: La CrosseLA CROSSE, WI 54601333 VINE STREET, ROOM 740
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1362MAYO CLINIC HEALTH SYSTEM FRANCISCAN MEDICAL CENTER INC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201709/01/1977
(608) 392-9793
(608) [email protected] KNUTSON
County: La CrosseLA CROSSE, WI 54601212 S 11TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2017 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2017 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 06/01/2017 05/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - HOLMEN CLINIC, 1303 MAIN STREET, HOLMEN, WI 546362
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - MENS RECOVERY HOUSE, 1005 JACKSON STREET, LA CROSSE, WI 54601
2
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - ONALASKA CLINIC, 191 THEATER ROAD, ONALASKA, WI 546502
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - PRAIRIE DU CHIEN CLINIC, 800 E BLACKHAWK AVENUE, PRAIRIE DU CHIEN, WI 53821
2
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - SPARTA, 310 WEST MAIN STREET, SPARTA, WI 546562
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - TOMAH, 325 BUTTS AVENUE, TOMAH, WI 546602
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN - WOMENS RECOVERY HOUSE, 518 SO 10TH STREET, LA CROSSE, WI 54601
2
06/01/2017 05/31/2019MAYO CLINIC FRANCISCAN MEDICAL CENTER, 800 WEST AVENUE SOUTH, LA CROSSE, WI 546012
06/01/2017 05/31/2019MAYO CLINIC FRANSISCAN - ARCADIA, 895 SO DETTLOFF DRIVE, ARCADIA, WI 546122
06/01/2017 05/31/2019MAYO CLINIC FRANSISCAN - GERARD HALL, 940 DIVISION STREET, LA CROSSE, WI 546012
1360MAYO CLINIC HEALTH SYSTEM - FRANCISCAN MEDICAL CENTER, INC MEN'S RECOVERY HOUSE
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/27/201701/01/1991
(608) 782-1811
(608) [email protected] SHERMAN
County: La CrosseLA CROSSE, WI 546011005 JACKSON STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/27/2017 03/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 04/27/2017 03/31/2019
Services
NO BRANCH LOCATIONS
2510MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC WOMEN'S RECOVERY HOUSE
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201803/19/2004
(608) 392-9511
(608) [email protected] CONWAY
County: La CrosseLA CROSSE, WI 54601518 SOUTH TENTH STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/01/2018 03/31/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3005PEACE OF MIND COUNSELING
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/01/2013
(608) 782-4426
(608) [email protected] CLARK
County: La CrosseLA CROSSE, WI 54601115 - 5TH AVENUE SOUTH, SUITE 507
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2018 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 07/31/2018PEACE OF MIND CNSLNG - WINONA MN, 902 E 2ND ST, SUITE 322, WINONA, MN 559872
05/26/2017 07/31/2018ARCADIA ELEMENTARY SCHOOL, 358 EAST RIVER ST, ARCADIA, WI 546123
05/26/2017 07/31/2018ARCADIA MIDDLE/HIGH SCHOOL, 756 RAIDER DR, ARCADIA, WI 546123
08/01/2016 07/31/2018BLAIR-TAYLOR SCHOOL DISTRICT, N31024 ELLAND ROAD, BLAIR, WI 546163
05/26/2017 07/31/2018CASHTON ELEMENTARY, 436 FRONT ST, CASHTON, WI 546193
03/28/2018 07/31/2018CATARACT ELEMENTARY SCHOOL, 6070 STATE HWY 27, SPARTA, WI 546563
08/01/2016 07/31/2018CENTRAL HIGH SCHOOL, 1801 LOSEY BLVD, LA CROSSE, WI 546013
08/01/2016 07/31/2018COCHRANE-FOUNTAIN CITY SCHOOL DISTRICT, S2770 STATE HIGHWAY 35, FOUNTAIN CITY, WI 54629
3
08/01/2016 07/31/2018COULEE CONNECTIONS, 99 MILWAUKEE ST, LA CROSSE, WI 546013
08/01/2016 07/31/2018COULEE REGION ALTERNATIVE SCHOOL, 20873 COLLEGE AVENUE, GALESVILLE, WI 546303
05/26/2017 07/31/2018DE SOTO MIDDLE/HIGH SCHOOL, 615 MAIN ST, DE SOTO, WI 546243
08/01/2016 07/31/2018EMERSON ELEMENTARY SCHOOL, 2102 CAMPBELL ROAD, LA CROSSE, WI 546013
08/01/2016 07/31/2018EVERGREEN ELEMENTARY, 510 LONG COULEE ROAD, HOLMEN, WI 546363
08/01/2016 07/31/2018G-E-T ELEMENTARY SCHOOL - GALESVILLE, 17151 FRENCH RD, GALESVILLE, WI 546303
08/01/2016 07/31/2018G-E-T HIGH SCHOOL, 17511 NORTH MAIN ST, GALESVILLE, WI 546303
08/01/2016 07/31/2018G-E-T MIDDLE SCHOOL, 19650 PRAIRIE RIDGE LANE, GALESVILLE, WI 546303
08/01/2016 07/31/2018HAMILTON ELEMENTARY SCHOOL, 1111 SOUTH 7TH STREET, LA CROSSE, WI 546013
03/28/2018 07/31/2018HIGH POINT CHARTER SCHOOL, 201 E FRANKLIN ST, SPARTA, WI 546563
08/01/2016 07/31/2018HOLMEN HIGH SCHOOL, 1001 MCHUGH ROAD, HOLMEN, WI 546363
08/01/2016 07/31/2018HOLMEN MIDDLE SCHOOL, 502 N MAIN STREET, HOLMEN, WI 546363
03/16/2017 07/31/2018INDEPENDENCE K-12, 23786 INDEE BLVD, INDEPENDENCE, WI 547473
08/01/2016 07/31/2018LA CRESCENT ELEMENTARY, 504 SOUTH OAK STREET, LA CRESCENT, MN 559473
08/01/2016 07/31/2018LA CRESCENT MS/HS, 1301 LANCER BLVD, LA CRESCENT, MN 559473
03/28/2018 07/31/2018LAKEVIEW MONTESSORI SCHOOL, 711 PINE ST, SPARTA, WI 546563
03/28/2018 07/31/2018LAWRENCE-LAWSON ELEMENTARY SCHOOL, 429 N BLACK RIVER ST, SPARTA, WI 546563
05/26/2017 07/31/2018LOGAN HIGH SCHOOL, 1500 RANGER DR, LA CROSSE, WI 546013
03/28/2018 07/31/2018MAPLEWOOD ELEMENTARY SCHOOL, 900 E MONTGOMERY ST, SPARTA, WI 546563
03/28/2018 07/31/2018MEADOWVIEW INTERMEDIATE SCHOOL, 125 N WATER ST, SPARTA, WI 546563
05/26/2017 07/31/2018NORTHSIDE ELEMENTARY, 1611 KANE ST, LA CROSSE, WI 546013
08/01/2016 07/31/2018ONALASKA HIGH SCHOOL, 700 HILLTOPPER PLACE, ONALASKA, WI 546503
08/01/2016 07/31/2018ONALASKA MIDDLE SCHOOL, 711 QUINCY STREET, ONALASKA, WI 546503
08/01/2016 07/31/2018PRAIRIE VIEW ELEMENTARY, 1201 NEWPORT LANE, HOLMEN, WI 546363
08/01/2016 07/31/2018SAND LAKE ELEMENTARY, 3600 SAND LAKE ROAD, HOLMEN, WI 546363
03/28/2018 07/31/2018SOUTHSIDE ELEMENTARY, 1023 WALRATH ST, SPARTA, WI 546563
03/28/2018 07/31/2018SPARTA ALT IND LEARNING SCHOOLS (SAILS), 201 E FRANKLIN ST, SPARTA, WI 546563
03/28/2018 07/31/2018SPARTA HIGH SCHOOL, 506 N BLACK RIVER ST, SPARTA, WI 546563
03/28/2018 07/31/2018SPARTA MEADOWVIEW MIDDLE SCHOOL, 1225 N BLACK RIVER ST, SPARTA, WI 546563
03/02/2017 07/31/2018STODDARD ELEMENTARY SCHOOL, 300 N. COTTAGE ST., STODDARD, WI 546583
08/01/2016 07/31/2018VIKING ELEMENTARY, 500 E WALL STREET, HOLMEN, WI 546363
08/01/2016 07/31/2018WHITEHALL SCHOOL DISTRICT, 19121 HOBSON ST, WHITEHALL, WI 547733
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Substance Abuse Program Directory By County, City, and Provider Name
3044WESTERN REGION INTEGRATED CARE CCS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201807/01/201607/04/2014
(608) 785-6122
(608) [email protected] ENGLING
County: La CrosseLA CROSSE, WI 54602300 - 4TH STREET NORTH
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 07/01/2016 06/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2016 06/30/2018JACKSON COUNTY HUMAN SERVICES - CCS, 420 COUNTY HWY 54 POX 457, BLACK RIVER FALLS,
WI 546152
07/01/2016 06/30/2018MONROE COUNTY HUMAN SERVICES CCS, 14301 COUNTY HWY B, SPARTA, WI 546562
3058WESTERN REGION INTEGRATED CARE CONSORTIUM (WRIC) CSP
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201811/01/2014
(608) 785-0002
(608) [email protected] ROHR
County: La CrosseLA CROSSE, WI 546011707 MAIN STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019FAMILY & CHILDREN'S CENTER, JACKSON COUNTY OFFICE, 221 MAIN ST., STE. L101, BLACK RIVER
FALLS, WI 546152
01/01/2018 12/31/2019FAMILY & CHILDREN'S CENTER, MONROE COUNTY OFFICE, 920 WEST WISCONSIN, SPARTA, WI 54656
2
ONALASKA
2971ADDICTION MEDICAL SOLUTIONS OF WISCONSIN LLC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201609/17/2012
(608) 783-0242
(608) [email protected] BOLAN
County: La CrosseONALASKA, WI 546509532 EAST 16 FRONTAGE RD #100
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 09/01/2016 08/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2019
Services
NO BRANCH LOCATIONS
2280GUNDERSEN LUTHERAN MEDICAL CENTER, INC., BEHAVIORAL HEALTH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/2000
(608) 775-8661
(608) [email protected] THOMPSON
County: La CrosseONALASKA, WI 54650123 - 16TH AVENUE, SOUTH
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 12/01/2016 11/30/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
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LAFAYETTEDARLINGTON
1490LAFAYETTE COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/01/1975
(608) 776-4914
(608) [email protected] SCHUHMACHER
County: LafayetteDARLINGTON, WI 5353015701 COUNTY ROAD K
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 11/01/2017 01/26/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2279LAFAYETTE COUNTY DEPARTMENT OF HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/01/2000
(608) 776-4914
(608) [email protected] SCHUHMACHER
County: LafayetteDARLINGTON, WI 5353015701 COUNTY ROAD K
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2017 10/31/2019
Services
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MANITOWOCKIEL
3060PATHWAYS TO A BETTER LIFE 1, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201804/13/2015
(920) [email protected] COOPER
County: ManitowocKIEL, WI 5304213111 LAX CHAPEL RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
3088PATHWAYS TO A BETTER LIFE 2, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201805/15/2015
(920) [email protected] THOMPSON
County: ManitowocKIEL, WI 5304213127 LAX CHAPEL RD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 05/01/2018 04/30/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
MANITOWOC
1555MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/01/1975
(920) 683-4243
(920) [email protected] FURE
County: ManitowocMANITOWOC, WI 54220926 S. 8TH STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 11/01/2017 10/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 11/01/2017 10/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2285MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT CSP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/01/1975
(920) 683-4243
(920) [email protected] FURE
County: ManitowocMANITOWOC, WI 54220926 S. 8TH STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 11/01/2017 10/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2017 10/31/2019
Services
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2711MANITOWOC COUNTY HUMAN SERVICES DEPT COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201702/06/2007
(920) 683-4243
(920) [email protected] FURE
County: ManitowocMANITOWOC, WI 54221926 S. 8TH STREET
CCS Affiliaton: 09/01/2014Begin: End: Lead:Northeastern Region CCS Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
TWO RIVERS
1591PHOENIX BEHAVIORAL HEALTH SERVICES, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201804/24/201708/26/1991
(920) 657-1784
(920) [email protected] EIDEN, PHD
County: ManitowocTWO RIVERS, WI 542413120 MEMORIAL DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/24/2017 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/24/2017 10/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier04/24/2017 10/31/2018PHOENIX BEHAVIORAL HEALTH SERVICES, LLC, 1121 NORTH 7TH STREET, SHEBOYGAN, WI 530811
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MARATHONABBOTSFORD
2180COURAGE TO CHANGE RECOVERY
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201701/07/2000
(715) 223-1611
(715) 223-0480rwichlacz@couragetochangereoveryRAE ANN WICHLACZ
County: MarathonABBOTSFORD, WI 54405106 GALVIN ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2017 10/31/2019COURAGE TO CHANGE RECOVERY, 880 E PERKINS, #102, MEDFORD, WI 544512
WAUSAU
2873ACS CLINICAL SERVICES, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201709/15/2009
(715) 355-0667
(715) [email protected] YEAGER
County: MarathonWAUSAU, WI 54403903 N 2ND STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
2464CHARIS COUNSELING, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/2003
(715) 848-8665
(715) [email protected] THOMPSON
County: MarathonWAUSAU, WI 544012620 W. STEWART AVENUE, #310
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018CHARIS COUNSELING, LLC, 2000 WEST 5TH ST, MARSHFIELD, WI 544491
09/01/2016 08/31/2018CHARIS COUNSELING, LLC, 101 W MC MILLAN STREET, #2B, MARSHFIELD, WI 544492
04/12/2017 08/31/2018MERRILL HIGH SCHOOL, 1201 N SALES STREET, MERRILL, WI 544523
04/12/2017 08/31/2018PRAIRIE RIVER MIDDLE SCHOOL, 106 POLK STREET, MERRILL, WI 544523
2349DIX & GILLETTE COUNSELING SERVICES, LLP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201802/01/2001
(715) 675-2988
(715) [email protected] DIX
County: MarathonWAUSAU, WI 544011720 MERRILL AVE SUITE 401
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2018 01/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2018 01/31/2020
Services
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1299ELMERGREEN ASSOCIATES, INC.
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/05/1992
(715) 845-7142
(715) [email protected] ELMERGREEN
County: MarathonWAUSAU, WI 54403114 GRAND AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2408MILWAUKEE HEALTH SERVICES SYSTEM, LLC DBA WAUSAU COMPREHENSIVE TREATMENT CTR
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201805/02/201601/13/2003
(715) 845-1977
(715) [email protected] ZELECHOWSKI
County: MarathonWAUSAU, WI 54403210 WASHINGTON STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 05/02/2016 08/31/2018
CSAS-NARCOTIC TREATMENT DHS 75.15 05/02/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/02/2016 08/31/2018
Services
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1677NORTH CENTRAL HEALTH CARE
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201710/01/1975
(715) 845-6050
(715) [email protected] LOY
County: MarathonWAUSAU, WI 544031100 LAKE VIEW DRIVE
Service Begin/End DatesAdm Code
CSAS-AMBULATORY DETOXIFICATION DHS 75.08 03/01/2017 02/28/2019
CSAS-DAY TREATMENT DHS 75.12 03/01/2017 02/28/2019
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 03/01/2017 02/28/2019
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 03/01/2017 02/28/2019
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 03/01/2017 02/28/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 03/01/2017 02/28/2019
MENTAL HEALTH-INPATIENT DHS 61.71 03/01/2017 02/28/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2017 02/28/2019ANTIGO CENTER, 1225 LANGLADE ROAD, ANTIGO, WI 544092
03/01/2017 02/28/2019MERRILL CENTER, 607 N SALES STREET, #309, MERRILL, WI 544522
03/01/2017 02/28/2019TOMAHAWK OFFICE, 213 WEST WISCONSIN AVE, TOMAHAWK, WI 544872
Setting Begin/End DatesNon-Certified School Setting(s)03/01/2017 02/28/2019ATHENS HIGH SCHOOL, 601 WEST LIMITS ROAD, ATHENS, WI 54411
03/01/2017 02/28/2019DC EVEREST JUNIOR HIGH, 1000 MACHMUELLER STREET, WESTON, WI 54476
03/01/2017 02/28/2019DC EVEREST MIDDLE SCHOOL, 302 SCHOFIELD AVENUE, WESTON, WI 54476
03/01/2017 02/28/2019DC EVEREST SENIOR HIGH, 6500 ALDERSON STREET, SCHOFIELD, WI 54476
03/01/2017 02/28/2019FRANKLIN ELEMENTARY SCHOOL, 1509 NORTH 5TH STREET, WAUSAU, WI 54403
03/01/2017 02/28/2019MARATHON HIGH SCHOOL, 204 EAST STREET, MARATHON, WI 54448
03/01/2017 02/28/2019MOSINEE ELEMENTARY SCHOOL, 600 12TH STREET, MOSINEE, WI 54455
03/01/2017 02/28/2019MOSINEE HIGH SCHOOL, 1000 HIGH STREET, MOSINEE, WI 54455
03/01/2017 02/28/2019MOSINEE MIDDLE SCHOOL, 700 HIGH STREET, MOSINEE, WI 54455
03/01/2017 02/28/2019RIVERSIDE ELEMENTARY SCHOOL, 12231 RIVER ROAD, RINGLE, WI 54471
03/01/2017 02/28/2019ROTHSCHILD ELEMENTARY SCHOOL, 810 1ST STREET, ROTHSCHILD, WI 54474
03/01/2017 02/28/2019THOMAS JEFFERSON ELEMENTARY SCHOOL, 500 WEST RANDOLPH STREET, WAUSAU, WI 54401
03/01/2017 02/28/2019WAUSAU EAST HIGH SCHOOL, 2607 NORTH 18TH STREET, WAUSAU, WI 54403
03/01/2017 02/28/2019WESTON ELEMENTARY SCHOOL, 5200 CAMP PHILLIPS ROAD, SCHOFIELD, WI 54406
3041NORTH CENTRAL HEALTH CARE CCS
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201807/01/2014
(715) 841-5146
(715) [email protected] HINTZ
County: MarathonWAUSAU, WI 544031100 LAKE VIEW DRIVE
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL UNIFIED BOARD DHS 36 01/01/2018 12/31/2019
CCS REGIONAL MODEL UNIFIED BOARD W/TELEHEALTH DHS 36 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019NORTH CENTRAL HEALTH CARE - LANGLADE COUNTY, 1225 LANGLADE ROAD, ANTIGO, WI 544092
01/01/2018 12/31/2019NORTH CENTRAL HEALTH CARE - LINCOLN COUNTY, 607 N SALES ST STE 309, MERRILL, WI 544522
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2297NORTH CENTRAL HEALTH CARE CSP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201810/01/1975
(715) 841-5146
(715) [email protected] HINTZ
County: MarathonWAUSAU, WI 544031100 LAKE VIEW DRIVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 01/01/2018 12/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019NORTH CENTRAL HEALTH CARE CSP - LANGLADE, 1225 LANGLADE ROAD, ANTIGO, WI 544092
01/01/2018 12/31/2019NORTH CENTRAL HEALTH CARE CSP - LINCOLN, 607 N SALES ST STE 309, MERRILL, WI 544522
2715PEACEFUL SOLUTIONS COUNSELING
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/01/2007
(715) 675-7238
(715) [email protected] SHIPWAY
County: MarathonWAUSAU, WI 54403741 NORTH 1ST STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2018 02/29/2020PEACEFUL SOLUTIONS COUNSELING, 726 EAST 2ND STREET, MERRILL, WI 544521
03/01/2018 02/29/2020EDGAR MIDDLE/HIGH SCHOOL, 203 E. BIRCH STREET, EDGAR, WI 544263
03/01/2018 02/29/2020WAUSAU EAST HIGH SCHOOL, 2607 NORTH 18TH STREET, WAUSAU, WI 544033
1909THE CENTRE FOR WELL-BEING, INC.
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201702/17/1992
(888) 778-6750
(715) [email protected] SALZMAN
County: MarathonWAUSAU, WI 54403901 N 6TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2019THE CENTRE FOR WELL-BEING, 1415 EAGLE STREET, RHINELANDER, WI 545011
10/19/2017 08/31/2019THE CENTRE FOR WELL-BEING, 6001 BUSINESS HWY 51 S, WESTON, WI 544762
09/01/2017 08/31/2019THE CENTRE FOR WELL-BEING, 607 CEDAR AVE, MERRILL, WI 544522
09/01/2017 08/31/2019LAC DU FLAMBEAU ELEMENTARY SCHOOL, 2899 HWY 47, LAC DU FLAMBEAU, WI 545383
10/19/2017 08/31/2019WAUSAU WEST HIGH SCHOOL, 1200 WEST WAUSAU AVENUE, WAUSAU, WI 544013
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WESTON
2939COMPASS COUNSELING WAUSAU, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201803/25/2011
(715) 848-5645
(715) [email protected] PETERSON
County: MarathonWESTON, WI 544763704 WESTON AVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020COMPASS COUNSELING WAUSAU, LLC, 420 THIRD ST S, WISCONSIN RAPIDS, WI 544942
04/01/2018 03/31/2020COMPASS COUNSELING WAUSAU, LLC, 530 GRANT ST, WAUSAU, WI 544032
04/01/2018 03/31/2020ADAMS FRIENDSHIP ELEMENTARY, 500 N PIERCE ST, ADAMS, WI 539103
04/01/2018 03/31/2020ADAMS FRIENDSHIP HIGH SCHOOL, 1109 E NORTH ST, ADAMS, WI 539103
04/01/2018 03/31/2020ADAMS FRIENDSHIP MIDDLE SCHOOL, 420 N MAIN ST, ADAMS, WI 539103
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Substance Abuse Program Directory By County, City, and Provider Name
MARINETTEMARINETTE
3074MARINETTE AND OCONTO COUNTY COMPREHENSIVE COMMUNITY SERVICES PROGRAM
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201610/01/2015
(715) 732-7711
(715) [email protected] GERBYSHAK
County: MarinetteMARINETTE, WI 541432500 HALL AVE
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 10/01/2016 09/30/2018
CCS REGIONAL MODEL MULTI-COUNTY W/TELEHEALTH DHS 36 10/01/2016 09/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2016 09/30/2018OCONTO COUNTY DEPT. OF HEALTH AND HUMAN SERVICES, 501 PARK AVE., OCONTO, WI 541531
1559MARINETTE COUNTY HEALTH & HUMAN SERVICES DEPARTMENT / ADAPT
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201701/01/1982
(715) 732-7711
(715) [email protected] FREEMAN
County: MarinetteMARINETTE, WI 541432500 HALL AVENUE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 12/01/2017 11/30/2019
CSAS-EMERGENCY OUTPATIENT WITH TELEHEALTH DHS 75.05 12/01/2017 11/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 12/01/2017 11/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 12/01/2017 11/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2019MARINETTE COUNTY HHSD/ADAPT, 1201 JACKSON STREET, NIAGARA, WI 541512
2340MARINETTE COUNTY HEALTH & HUMAN SERVICES DEPARTMENT/ADAPT CSP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201701/01/1982
(715) 732-7667
(715) [email protected] BREAULT
County: MarinetteMARINETTE, WI 541432500 HALL AVENUE, #A
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
3117ST VINCENT HHS OF THE THIRD ORDER OF ST FRANCIS DBA LIBERTAS OF MARINETTE
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/01/2016
(715) 735-0094
(715) [email protected] BEHNKE
County: MarinetteMARINETTE, WI 541431409 CLEVELAND AVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
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MARQUETTEMONTELLO
1560MARQUETTE COUNTY HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201805/01/201603/01/1981
(608) 297-2148
(608) [email protected] RASMUSSEN
County: MarquetteMONTELLO, WI 53949480 UNDERWOOD AVE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 05/01/2016 04/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2016 04/30/2018
CSAS-PREVENTION DHS 75.04 05/01/2016 04/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2016 04/30/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/01/2016 04/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 05/01/2016 04/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier10/22/2016 04/30/2018MONTELLO SCHOOLS, 222 FOREST LANE, MONTELLO, WI 539493
10/22/2016 04/30/2018WESTFIELD ELEMENTARY SCHOOL, 329 HAWK LANE, WESTFIELD, WI 539643
10/22/2016 04/30/2018WESTFIELD MIDDLE/HIGH SCHOOL, N7046 COUNTY ROAD M, WESTFIELD, WI 539643
3108MARQUETTE COUNTY HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/01/2016
(608) 297-2148
(608) [email protected] STARKS
County: MarquetteMONTELLO, WI 53949480 UNDERWOOD AVE
CCS Affiliaton: 01/01/2016Begin: End: Lead:Central Wisconsin Health Partnership V2
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 01/01/2017 12/31/2018
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
3125MARQUETTE COUNTY HUMAN SERVICES - CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/28/2016
(608) 297-2148
(608) [email protected] RASMUSSEN
County: MarquetteMONTELLO, WI 53949480 UNDERWOOD AVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 03/01/2017 02/28/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
MENOMINEEKESHENA
1587MENOMINEE COUNTY HEALTH & HUMAN SERVICES DEPARTMENT
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201711/01/1994
(715) 799-3517
(715) [email protected] KIELBLOCK
County: MenomineeKESHENA, WI 54135W3272 WOLF RIVER ROAD
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 05/01/2017 04/30/2019
CSAS-EMERGENCY OUTPATIENT WITH TELEHEALTH DHS 75.05 05/01/2017 04/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2017 04/30/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/01/2017 04/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 05/01/2017 04/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
2228MENOMINEE COUNTY HEALTH & HUMAN SERVICES DEPARTMENT CSP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201711/01/1994
(715) 799-3517
(715) [email protected] KIELBLOCK
County: MenomineeKESHENA, WI 54135W3272 WOLF RIVER ROAD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
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MILWAUKEEBROWN DEER
2882REACH, INC. COMPREHENSIVE MENTAL HEALTH CLINIC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/2009
(414) 961-1616
(414) [email protected] YELVINGTON
County: MilwaukeeBROWN DEER, WI 532234550 W BRADLEY ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
2532ROGERS MEMORIAL HOSPITAL - CHILD & ADOLESCENT DAY TREATMENT
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/13/2004
(414) 355-9665
(414) [email protected] SCHULTZ
County: MilwaukeeBROWN DEER, WI 532234555 W SCHROEDER DRIVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2017 06/30/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 07/01/2017 06/30/2019
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 2 DHS 40.11(2)(B) 07/01/2017 06/30/2019
MENTAL HEALTH-DAY TREATMENT WITH TELEHEALTH DHS 61.75 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
3084ROGERS MEMORIAL HOSPITAL, INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/28/2015
(262) 646-1330
(414) [email protected] SCHULTZ
County: MilwaukeeBROWN DEER, WI 532234600 WEST SCHROEDER DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 04/01/2018 03/31/2020
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 04/01/2018 03/31/2020
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 04/01/2018 03/31/2020
MENTAL HEALTH-INPATIENT DHS 61.71 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
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CUDAHY
1867AURORA HEALTH CARE METRO, INC. DBA AURORA ST. LUKE'S SOUTH SHORE
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201611/01/1989
(414) 489-4056
(414) [email protected] SHANKS
County: MilwaukeeCUDAHY, WI 531105900 S. LAKE DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 10/01/2016 09/30/2018
MENTAL HEALTH-INPATIENT DHS 61.71 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
FRANKLIN
1650AURORA BEHAVIORAL HEALTH - FRANKLIN
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201907/31/201705/02/1994
(417) 773-4352
(414) [email protected] MONSON-DUPUIS
County: MilwaukeeFRANKLIN, WI 531329200 W. LOOMIS ROAD, #217
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/31/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/31/2017 04/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier07/31/2017 04/30/2019AURORA BEHAVIORAL HEALTH CENTER - LAYTON, 2000 E. LAYTON AVE., STE 250, SAINT FRANCIS,
WI 532352
07/31/2017 04/30/2019AURORA BEHAVIORAL HEALTH CENTER-LAKESHORE, 3611 CHICAGO AVE, SOUTH MILWAUKEE, WI 53172
2
07/31/2017 04/30/2019AURORA BEHAVIORAL SERVICES-MUSKEGO WEST, S74W16775 JANESVILLE RD, MUSKEGO, WI 53150
2
GLENDALE
3155AURORA PSYCHIATRIC HOSPITAL INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/29/2016
(414) 454-6450
(414) [email protected] SURFUS-LEWISTON
County: MilwaukeeGLENDALE, WI 532176980 N PORT WASHINGTON ROAD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 09/01/2017 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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2367LA CAUSA, INC.
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201704/22/2002
(414) 771-7497
(414) [email protected] CORTEZ
County: MilwaukeeGLENDALE, WI 532095235 N IRONWOOD ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
1836SHOREHAVEN BEHAVIORAL HEALTH INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/1983
(414) 540-2171
(414) [email protected] GODEC
County: MilwaukeeGLENDALE, WI 532093900 W BROWN DEER ROAD #200
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020SHOREHAVEN BEHAVIORAL HEALTH INC, 4370 SOUTH 76TH STREET, GREENFIELD, WI 532202
07/01/2018 06/30/2020SHOREHAVEN BEHAVIORAL HEALTH, INC., 2607 N GRANDVIEW BLVD., # 102, WAUKESHA, WI 531882
07/01/2018 06/30/2020SHOREHAVEN BEHAVIORAL HEALTH, INC., 6233 DURAND AVE #F, RACINE, WI 534062
GREENFIELD
1095BELL THERAPY COMMUNITY SUPPORT PROGRAM SOUTH
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201703/03/1997
(414) 210-2222
(414) [email protected] ZOCH
County: MilwaukeeGREENFIELD, WI 532284420 SOUTH 108TH STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
3091SERENITY RECOVERY CLINIC LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201805/08/2015
(414) 763-7755
(414) [email protected] LUZNICKY CSAC
County: MilwaukeeGREENFIELD, WI 532206510 W LAYTON AVE, STE 5
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
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MILWAUKEE
26822ND CENTURY
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201708/30/2006
(414) 321-5935
(414) [email protected] SANCHEZ
County: MilwaukeeMILWAUKEE, WI 532272187 S 85TH STREET
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
2982A STRONG FOUNDATION COUNSELING SERVICES, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201612/01/201511/06/2012
(414) 967-7991
(414) [email protected] COLLINS
County: MilwaukeeMILWAUKEE, WI 532114447 N OAKLAND AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 12/01/2015 10/31/2016
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2015 10/31/2016
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2015 10/31/2016
Services
NO BRANCH LOCATIONS
3119ACCESS RECOVERY MENTAL HEALTH SERVICES (ARMHS)
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/10/2016
(414) 455-1915
(414) [email protected] YAROW
County: MilwaukeeMILWAUKEE, WI 532152727 WEST CLEVELAND AVE, #204
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2018 02/29/2020
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
2992ACS CLINICAL SERVICES LLC - MILWAUKEE
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201803/01/201603/01/2013
(414) 277-7938
(414) [email protected] SCHABEL
County: MilwaukeeMILWAUKEE, WI 532022266 N PROSPECT AVE, SUITES 204 & 520
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 02/28/2018
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2016 02/28/2018ACS CLINICAL SERVICES, LLC - MADISON, 7017 RAYWOOD ROAD, MADISON, WI 537132
03/01/2016 02/28/2018ACS CLINICAL SERVICES, LLC - WAUKESHA, 217 WISCONSIN AVE, SUITE 209, WAUKESHA, WI 531872
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Substance Abuse Program Directory By County, City, and Provider Name
2406AIDS RESOURCE CENTER OF WISCONSIN
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201710/02/2002
(414) 225-1628
(414) [email protected] LEWIS
County: MilwaukeeMILWAUKEE, WI 53203820 N. PLANKINTON AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/01/2017 12/31/2018
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 08/09/2017 12/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 08/09/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 08/09/2017 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2017 12/31/2018AIDS RESOURCE CENTER OF WI-KENOSHA, 1212 - 57TH STREET, KENOSHA, WI 531401
01/01/2017 12/31/2018AIDS RESOURCE CENTER OF WI-LA CROSSE, 505 KING STREET, LA CROSSE, WI 546011
01/01/2017 12/31/2018AIDS RESOURCE CENTER OF WISCONSIN, 633 C WEST WISCONSIN AVE, APPLETON, WI 549111
01/01/2017 12/31/2018AIDS RESOURCE CENTER OF WI-WAUSAU, 1105 GRAND AVENUE, #1, WAUSAU, WI 544031
01/01/2017 12/31/2018AIDS RESOURCE ENTER OF WI-EAU CLAIRE, 505 DEWEY STREET SOUTH, #107, EAU CLAIRE, WI 54702
1
01/01/2017 12/31/2018ARCW, 136 W. GRAND AVENUE, BELOIT, WI 535111
01/01/2017 12/31/2018ARCW, 600 WILLIAMS STREET, MADISON, WI 537031
01/01/2017 12/31/2018AIDS RESOURCE CENTER OF WI-GREEN BAY, 445 S ADAMS STREET, GREEN BAY, WI 543012
2875AMRI COUNSELING SERVICES, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/01/2009
(866) 719-3024
(414) [email protected] JONES
County: MilwaukeeMILWAUKEE, WI 532164001 WEST CAPITOL DRIVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/01/2016 07/31/2018
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 08/01/2016 07/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 07/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 08/01/2016 07/31/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 08/01/2016 07/31/2018
MENTAL HEALTH-DAY TREATMENT WITH TELEHEALTH DHS 61.75 08/01/2016 07/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 07/31/2018AMRI COUNSELING SERVICES, 6321 23RD AVENUE, KENOSHA, WI 531431
11/01/2017 07/31/2018MILWAUKEE ACADEMY OF SCIENCE, 2000 W KILBOURN AVE, MILWAUKEE, WI 532333
3069ARC MILWAUKEE WOMEN'S PROGRAM
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201712/11/2014
(414) 837-6062
(414) [email protected] WOLKOMIR
County: MilwaukeeMILWAUKEE, WI 532011022 W MADISON STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
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3146ARUNAOBI INTEGRATED MEDICAL BEHAVIORAL HEALTH CLINIC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201710/06/2016
(414) 810-0587
(414) [email protected] A ANIAKUDO
County: MilwaukeeMILWAUKEE, WI 532105325 W BURLEIGH ST
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 09/01/2017 08/31/2018
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 09/01/2017 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2017 08/31/2018
Services
NO BRANCH LOCATIONS
1335AURORA BEHAVIORAL HEALTH NORTH SHORE
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/01/1985
(414) 454-6450
(414) [email protected] MONSON-DUPUIS
County: MilwaukeeMILWAUKEE, WI 532176980 N PORT WASHINGTON #202
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 07/31/2018AURORA BEHAVIORAL HEALTH - HARTFORD, 1640 E SUMNER STREET, HARTFORD, WI 530271
08/01/2016 07/31/2018AURORA BEHAVIORAL HEALTH - GRAFTON, 975 N. PORT WASHINGTON RD, GRAFTON, WI 530242
08/01/2016 07/31/2018AURORA BEHAVIORAL HEALTH - WEST BEND, 205 VALLEY AVENUE, WEST BEND, WI 530952
1839AURORA BEHAVIORAL HEALTH CENTER - SINAI
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201810/01/1987
(414) 454-6450
(414) [email protected] MONSON-DUPUIS
County: MilwaukeeMILWAUKEE, WI 532331020 N 12TH ST 4TH FLOOR
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
1093BELL THERAPY INC COMMUNITY SUPPORT PROGRAM NORTH
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201709/01/1990
(414) 871-2552
(414) [email protected] WRIGHT
County: MilwaukeeMILWAUKEE, WI 532164929 W FOND DU LAC AVENUE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
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2456BENEDICT CENTER WOMEN'S HARM REDUCTION PROGRAM
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/15/2003
(414) 347-0148
(414) [email protected] PERRY
County: MilwaukeeMILWAUKEE, WI 532121849 MARTIN LUTHER KING DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
1870COLUMBIA ST. MARY'S BEHAVIORAL MEDICINE - MILWAUKEE
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201806/01/1981
(414) 585-1969
(414) [email protected] MCGLYNN
County: MilwaukeeMILWAUKEE, WI 532112323 N LAKE DRIVE, 7TH FLOOR
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/01/2018 12/31/2019
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 01/01/2018 12/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
1215COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE CAMPUS
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201807/01/201607/01/2015
(414) 585-1924
(414) [email protected] PEERBOLT
County: MilwaukeeMILWAUKEE, WI 532112301 N LAKE DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 07/01/2016 06/30/2018
MENTAL HEALTH-INPATIENT DHS 61.71 07/01/2016 06/30/2018
Services
NO BRANCH LOCATIONS
3123COMMUNITY ADVOCATES, PUBLIC POLICY INSTITUTE
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201705/01/2016
(414) 270-2971
(414) [email protected] ELLIOT
County: MilwaukeeMILWAUKEE, WI 53233728 N JAMES LOVELL STREET
Service Begin/End DatesAdm Code
CSAS-PREVENTION DHS 75.04 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3153CROSSROADS COGNITIVE BEHAVIORAL SERVICES
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201804/01/201810/01/2016
(414) 562-6361
(414) [email protected] MCCLENDON
County: MilwaukeeMILWAUKEE, WI 532052454 WEST LISBON AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 09/30/2018
Services
NO BRANCH LOCATIONS
2953EMPATHETIC COUNSELING SERVICES INC.
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/2011
(414) 332-2523
(414) [email protected] BROUGHTON LEWIS
County: MilwaukeeMILWAUKEE, WI 532166815 WEST CAPITOL DRIVE #311
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2018EMPATHETIC COUNSELING SERVICES SOUTH, 610 WEST LINCOLN AVE SUITE 2C, MILWAUKEE, WI
532042
2473FOKUS FAMILY SERVICES
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/01/2014
(414) 264-4218
(414) [email protected] COLLINS
County: MilwaukeeMILWAUKEE, WI 532122821 N. 4TH STREET, #139
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
3174FOREVER FREE SUBSTANCE ABUSE & MENTAL HEALTH TREATMENT CENTER
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/24/201708/24/2017
(414) 383-8627
(414) [email protected] CHARLES GREEN
County: MilwaukeeMILWAUKEE, WI 53215724 S LAYTON BLVD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/24/2017 07/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2479GATEWAY TO CHANGE
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201610/29/2003
(414) 442-2167
(414) [email protected] HAMPTON
County: MilwaukeeMILWAUKEE, WI 532062319 W. CAPITOL DRIVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 12/01/2016 11/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1383GENESIS BEHAVIORAL SERVICES, INC. MEN'S AODA RESIDENTIAL
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201801/01/201707/15/1992
(414) 449-3993
(414) [email protected] SANCHEZ
County: MilwaukeeMILWAUKEE, WI 532102436 N 50TH STREET
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 01/01/2017 07/31/2018
Services
NO BRANCH LOCATIONS
2803GRO FAMILY SERVICES
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201902/21/201808/28/2008
(414) 395-4716
(414) [email protected] OWENS
County: MilwaukeeMILWAUKEE, WI 532102436 NORTH 50TH STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 02/21/2018 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/21/2018 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/21/2018 07/31/2019
Services
NO BRANCH LOCATIONS
2101GUEST HOUSE COUNSELING CLINIC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201707/15/1992
(414) 345-3258
(414) [email protected] VAREKA
County: MilwaukeeMILWAUKEE, WI 532051216 N. 13TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
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2174HORIZON HEALTHCARE INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201711/01/1999
(414) 762-9727
(414) [email protected] SANCHEZ
County: MilwaukeeMILWAUKEE, WI 532074650 S HOWELL AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/16/2018 11/30/2019HORIZON HEALTHCARE INC, 1146 GRANT STREET, BELOIT, WI 535112
12/01/2017 11/30/2019HORIZON HEALTHCARE INC, 1648 WASHINGTON AVENUE, RACINE, WI 534032
12/01/2017 11/30/2019HORIZON HEALTHCARE INC, 3410 80TH STREET, KENOSHA, WI 531422
12/01/2017 11/30/2019HORIZON HEALTHCARE INC, 5408 W BURLEIGH ST, MILWAUKEE, WI 532102
3087INNER CITY BEHAVIORAL SERVICES, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/01/2015
(414) 444-2732
(414) [email protected] TRIPP
County: MilwaukeeMILWAUKEE, WI 532083341 WEST NORTH AVENUE #101
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
2033JEANNETTA ROBINSON HOUSE
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201907/07/201705/15/1998
(414) 536-3708
(414) [email protected] SANCHEZ
County: MilwaukeeMILWAUKEE, WI 532185427 W VILLARD STREET
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 07/07/2017 05/31/2019
Services
NO BRANCH LOCATIONS
1876LAD LAKE - ST ROSE CENTER
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201607/05/1985
(414) 466-0730
(414) [email protected] WALDRON
County: MilwaukeeMILWAUKEE, WI 532223801 N. 88TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018LAD LAKE, INC. DOUSMAN, W350 - S1401 WATERVILLE ROAD, DOUSMAN, WI 531181
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Substance Abuse Program Directory By County, City, and Provider Name
3045LIFE CHANGING MINISTRIES INC.
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/16/2014
(414) 755-0698
(414) [email protected] CHELSKY
County: MilwaukeeMILWAUKEE, WI 532051134 W NORTH AVE, 2ND FLOOR
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
3039LOCKETT ENTERPRISES, LLC BEHAVIORAL HEALTH SERVICES
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201707/29/2014
(414) 223-3817
(414) [email protected] LOCKETT JR.
County: MilwaukeeMILWAUKEE, WI 532021845 NORTH FARWELL AVE SUITE 301
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
1573MATT TALBOT RECOVERY CENTER
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201802/07/1997
(414) 342-5476
(414) [email protected] SANCHEZ
County: MilwaukeeMILWAUKEE, WI 532052613 W. NORTH AVENUE
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
3072MATT TALBOT RECOVERY SERVICES INC (FIRST STEP COMMUNITY RECOVERY CTR)
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201802/05/2015
(414) 301-6383
(414) [email protected] SANCHEZ
County: MilwaukeeMILWAUKEE, WI 532102835 N 32ND STREET
Service Begin/End DatesAdm Code
CSAS-AMBULATORY DETOXIFICATION DHS 75.08 02/01/2018 01/31/2020
CSAS-MEDICALLY MONITORED RESIDENTIAL DETOX DHS 75.07 02/01/2018 01/31/2020
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
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3062MATTERS OF THE SPIRIT, LLC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201801/01/2015
(414) 393-0492
(414) [email protected] TINA SANFORD
County: MilwaukeeMILWAUKEE, WI 532226815 WEST CAPITOL DRIVE, SUITE 112
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2018 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2018 05/31/2019
Services
NO BRANCH LOCATIONS
1580MCW DEPARTMENT OF PSYCHIATRY CLINICS AT TOSA
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201707/01/1996
(414) 955-6285
(414) [email protected] G MILLER
County: MilwaukeeMILWAUKEE, WI 532261155 N MAYFAIR ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2017 01/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 02/01/2017 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2017 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
2225MD THERAPY
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201805/05/2000
(414) 466-3206
(414) [email protected] (MIKE) DALE
County: MilwaukeeMILWAUKEE, WI 532166815 W CAPITOL DRIVE, #208
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2018 05/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
1619META HOUSE, INC (SHOREWOOD CAMPUS) AKA META III
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201702/01/1995
(414) 962-2305
(414) [email protected] ULLSTRUP
County: MilwaukeeMILWAUKEE, WI 532113924-26 N. MARYLAND AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 02/01/2017 01/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2022META HOUSE, INC (SOUTH CAMPUS) AKA RIVERWEST
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201705/20/1998
(414) 962-2305
(414) [email protected] ULLSTRUP
County: MilwaukeeMILWAUKEE, WI 532122618 N. BREMEN STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 02/01/2017 01/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
2172META HOUSE, INC.
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201711/24/1999
(414) 962-2305
(414) [email protected] ULLSTRUP
County: MilwaukeeMILWAUKEE, WI 532122625 N WEIL STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 12/01/2017 11/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
1620META HOUSE, INC. (NORTH CAMPUS)
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201702/01/1995
(414) 962-2305
(414) [email protected] ULLSTRUP
County: MilwaukeeMILWAUKEE, WI 532122626 N. BREMEN STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 08/01/2017 07/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
1933MILWAUKEE CENTER FOR INDEPENDANCE DBA WHOLE HEALTH CLINICAL GROUP
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201709/01/1985
(414) 615-0627
(414) [email protected] MCGUIRE
County: MilwaukeeMILWAUKEE, WI 53214932 S 60TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2017 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2017 05/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2017 05/31/2019CRISIS RESOURCE CENTER, 2057 S 14TH STREET, MILWAUKEE, WI 532041
06/01/2017 05/31/2019CRISIS RESOURCE CENTER, 5409 W VILLARD AVE, MILWAUKEE, WI 532181
06/01/2017 05/31/2019NEXDAY, 3333 SOUTH HOWELL AVE, MILWAUKEE, WI 532071
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Substance Abuse Program Directory By County, City, and Provider Name
3037MILWAUKEE COUNTY COMPREHENSIVE COMMUNITY SERVICES PROGRAM
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/01/2014
(414) 257-8085
AMY LORENZ
County: MilwaukeeMILWAUKEE, WI 532269455 WEST WATERTOWN PLANK ROAD
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL POPULATION-BASED DHS 36 09/01/2017 08/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2019MILWAUKEE CO DISABILITY SVS, 1220 W VLIET ST, MILWAUKEE, WI 532051
10/23/2017 08/31/2019ALTERNATIVES IN PSYCHOLOGICAL CONSULTATION, 6737 W WASHINGTON ST #1325, WEST ALLIS, WI 53214
2
09/01/2017 08/31/2019ALTERNATIVES IN PSYCHOLOGICAL CONSULTATION, SC, 10045 W LISBON AVENUE, MILWAUKEE, WI 53222
2
09/01/2017 08/31/2019BELL THERAPY, INC, 3090 N 53RD STREET, MILWAUKEE, WI 532102
09/01/2017 08/31/2019JUSTICE POINT, 205 W HIGHLAND AVE #314, MILWAUKEE, WI 532332
09/01/2017 08/31/2019LA CAUSA, INC, 5235 N IRONWOOD RD, GLENDALE, WI 532172
09/01/2017 08/31/2019MCFI DBA WHOLE HEALTH GROUP, 932 SOUTH 60TH STREET, MILWAUKEE, WI 532142
09/01/2017 08/31/2019MILWAUKEE MENTAL HEALTH ASSOCIATES, INC, 3975 N 68TH STREET, MILWAUKEE, WI 532162
09/01/2017 08/31/2019OUTREACH COMMUNITY HEALTH CENTERS, INC, 711 W CAPITOL DRIVE, MILWAUKEE, WI 532062
09/01/2017 08/31/2019PROJECT ACCESS, INC, 823 S 60TH ST, MILWAUKEE, WI 532142
09/29/2017 08/31/2019SAINT A, 8901 W CAPITOL DR, MILWAUKEE, WI 532222
09/01/2017 08/31/2019ST CHARLES YOUTH & FAMILY SERVICES, INC, 4757 N 76TH STREET, MILWAUKEE, WI 532182
09/01/2017 08/31/2019THE GUEST HOUSE OF MILWAUKEE, 1216 N 13TH STREET, MILWAUKEE, WI 532052
09/01/2017 08/31/2019WISCONSIN COMMUNITY SERVICES, 3732 W WISCONSIN AVE. SUITE 200, MILWAUKEE, WI 532082
1644MILWAUKEE HEALTH SERVICES SYSTEM, LLC DBA 10TH STREET COMPREHENSIVE TREATMENT CT
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201610/01/1995
(414) 744-9052
(414) [email protected] CRANE
County: MilwaukeeMILWAUKEE, WI 532214800 S 10TH STREET #1
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
1643MILWAUKEE HEALTH SERVICES SYSTEM, LLC DBA RIVERS SHORE COMPREHENSIVE TREATMENT C
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201611/01/1986
(414) 967-7020
(414) [email protected] OKETCH
County: MilwaukeeMILWAUKEE, WI 532123707 N RICHARDS STREET
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
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1645MILWAUKEE MENTAL HEALTH ASSOCIATES COMMUNITY SUPPORT PROGRAM
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201702/18/1997
(414) 873-4990
(414) [email protected] NOBLE
County: MilwaukeeMILWAUKEE, WI 532163975 N 68TH STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 08/01/2017 07/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier10/16/2017 07/31/2019MILWAUKEE MENTAL HEALTH ASSOCIATES, INC - NATIONAL, 3073 S CHASE AVE, SUITE 100,
MILWAUKEE, WI 532072
2891MINDSTAR COUNSELING, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201806/15/201712/01/2009
(414) 435-0543
(414) 435-1115mindstarcounseling@mindstarcounsSTARLETTE PATTERSON
County: MilwaukeeMILWAUKEE, WI 532227900 W BURLEIGH STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 04/25/2018 11/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/23/2018 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/15/2017 11/30/2018
Services
NO BRANCH LOCATIONS
1794MWCCA BEHAVIORAL HEALTH CLINIC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201908/01/201702/01/1988
(414) 270-2971
(414) [email protected] LOCKETT JR
County: MilwaukeeMILWAUKEE, WI 532164906 W FOND DU LAC AVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
2930NEW CHOICES, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201710/14/2010
(414) 444-8432
(414) [email protected] WILLIAMS
County: MilwaukeeMILWAUKEE, WI 532123565 N MARTIN LUTHER KING DR
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2413OMNI ENRICHMENT, INC.
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201702/01/2003
(414) 455-3292
(414) [email protected] TRIPP
County: MilwaukeeMILWAUKEE, WI 532083020 W. VLIET STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
1777OUTREACH COMMUNITY HEALTH CENTER INC RECOVERY CSP
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/17/1996
(414) 374-7917
(414) [email protected] GABRIEL
County: MilwaukeeMILWAUKEE, WI 53206711 W CAPITOL DRIVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
2246OUTREACH COMMUNITY HEALTH CENTERS INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/01/2000
(414) 727-6321
(414) [email protected] SANDERS
County: MilwaukeeMILWAUKEE, WI 53212210 W CAPITOL DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2017 07/31/2019OUTREACH COMMUMITY HEALTH CENTERS, 9120 W HAMPTON AVE, MILWAUKEE, WI 532252
08/01/2017 07/31/2019OUTREACH COMMUNITY HEALTH CENTER, 711 W CAPITOL DRIVE, MILWAUKEE, WI 532062
2990PARADIGM ENRICHMENT SERVICES, INC.
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/25/2013
(414) 393-1155
(414) [email protected] JACKSON II
County: MilwaukeeMILWAUKEE, WI 532164222 WEST CAPITOL DRIVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3152PATHWAY YOUTH & FAMILY SERVICES
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201711/30/201611/30/2016
(414) 539-3636
(414) [email protected] RICHARDSON
County: MilwaukeeMILWAUKEE, WI 532123879 N PORT WASHINGTON RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/30/2016 10/31/2017
Services
NO BRANCH LOCATIONS
2796POSITIVE OUTLOOK CLINICAL SERVICES LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201801/06/201708/01/2008
(414) 355-5467
(414) [email protected] HANSEN
County: MilwaukeeMILWAUKEE, WI 532166815 W CAPITOL DR, SUITE 304
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/06/2017 07/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/06/2017 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/06/2017 07/31/2018
Services
NO BRANCH LOCATIONS
1751PROJECT ACCESS, INC. CSP
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201712/20/1995
(414) 456-1655
(414) [email protected] ROGER ZHONG
County: MilwaukeeMILWAUKEE, WI 53214823 S 60TH STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
2118RAVENSWOOD CLINIC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201706/23/1999
(414) 224-8112
(414) [email protected] F. WERTH, JR.
County: MilwaukeeMILWAUKEE, WI 532022266 N. PROSPECT AVENUE, #326
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 09/01/2017 08/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
1792RENEW COUNSELING SERVICES
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201704/01/1985
(414) 727-8730
(414) [email protected] CROATT
County: MilwaukeeMILWAUKEE, WI 532041225 W. MITCHELL STREET, #223
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3181RESURRECTION CONSULTING SERVICES INC RCS
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/29/201708/29/2017
(414) 488-9850
(414) [email protected] ROSS
County: MilwaukeeMILWAUKEE, WI 532106040 W LISBON AVE SUITE 104
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/29/2017 07/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/29/2017 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/29/2017 07/31/2018
Services
NO BRANCH LOCATIONS
3038ROOTS COUNSELING SERVICES
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/16/2014
(414) 446-3317
(414) [email protected] A. JAEGER
County: MilwaukeeMILWAUKEE, WI 532021681 N PROSPECT AVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
3175SAQH
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201801/16/201809/25/2017
(414) 431-8608
(414) [email protected] ALI
County: MilwaukeeMILWAUKEE, WI 532124111 N PORT WASHINGTON RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/16/2018 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/16/2018 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier05/02/2018 08/31/2018SAQH WEST, 13000 W BLUEMOUND RD, ELM GROVE, WI 531222
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Substance Abuse Program Directory By County, City, and Provider Name
2495SEBASTIAN FAMILY PSYCHOLOGY PRACTICE LLC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/14/2004
(414) 247-0816
(414) [email protected] SSEMPIJJA
County: MilwaukeeMILWAUKEE, WI 532091720 W FLORIST AVENUE #125
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/01/2017 12/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2017 12/31/2018SEBASTIAN FAMILY PSYCHOLOGY, 2745 W LAYTON AVE, STE 203, MILWAUKEE, WI 532211
01/01/2017 12/31/2018AUDUBON TECHNOLOGY & COMMUNICATION CENTER, 3300 S 39TH ST, MILWAUKEE, WI 532153
01/25/2017 12/31/2018BENJAMIN FRANKLIN SCHOOL, 2308 W NASH ST, MILWAUKEE, WI 532063
01/25/2017 12/31/2018BETHUNE ACADEMY, 1535 N 35TH ST, MILWAUKEE, WI 532083
01/25/2017 12/31/2018HENRY DAVID THOREAU, 7878 N 60TH ST, MILWAUKEE, WI 532233
01/25/2017 12/31/2018MILW COLLEGE PREP LLOYD ST, 1228 W LLOYD ST, MILWAUKEE, WI 532053
01/01/2017 12/31/2018OLIVER WENDALL HOLMES SCHOOL, 2463 N BUFFUM ST, MILWAUKEE, WI 532123
01/25/2017 12/31/2018SHERMAN MULTICULTURAL ARTS SCHOOL, 5110 W LOCUST ST, MILWAUKEE, WI 532103
01/25/2017 12/31/2018ST CATHERINE SCHOOL, 2647 N 51ST ST, MILWAUKEE, WI 532103
2945SHECAR SUBSTANCE ABUSE/MENTAL HEALTH OUTPATIENT TREATMENT CENTER, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201709/01/201706/27/2011
(414) 372-3964
(414) [email protected] R RAMOS
County: MilwaukeeMILWAUKEE, WI 532122821 N 4TH STREET, #120
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 09/01/2017 09/30/2017
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 09/30/2017
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 09/30/2017
Services
NO BRANCH LOCATIONS
3199SIXTEENTH STREET COMMUNITY HEALTH CENTERS - LAYTON
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201804/01/2018
(414) 383-5597
(414) [email protected] ELENA PEREZ, PHD
County: MilwaukeeMILWAUKEE, WI 532214570 S 27TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2019
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 1 DHS 40.11(2)(A) 04/01/2018 03/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3201SMILE INC MENTAL HEALTH AND AODA OUTPATIENT CLINIC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/02/201804/02/2018
(414) 249-3312
(262) [email protected] VEASEY
County: MilwaukeeMILWAUKEE, WI 532164222 W CAPITOL DR #308
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 04/02/2018 03/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/02/2018 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/02/2018 03/31/2019
Services
NO BRANCH LOCATIONS
2373SOCIAL DEVELOPMENT COMMISSION YOUTH & FAMILY DEVELOPMENT PROGRAM
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202006/01/201804/29/2002
(414) 963-2691
(414) 906-2704
SHEILA SAMPTON
County: MilwaukeeMILWAUKEE, WI 532051730 W NORTH AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2018 08/31/2018
Services
NO BRANCH LOCATIONS
1322ST. CHARLES YOUTH & FAMILY SERVICES - FAMILY DEVELOPMENT CENTER
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201701/01/1991
(414) 358-5005
(414) [email protected] UNDERWOOD
County: MilwaukeeMILWAUKEE, WI 532184757 N. 76TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2017 01/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2017 01/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier02/01/2017 01/31/2019ST CHARLES - FAMILY DEVELOPMENT CENTER, 151 S 84TH STREET, MILWAUKEE, WI 532141
2690ST. LUKE'S MEDICAL CENTER OUTPATIENT BEHAVIORAL HEALTH CLINIC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201708/30/2006
(414) 454-6450
(414) [email protected] MONSON-DUPUIS
County: MilwaukeeMILWAUKEE, WI 532152900 W OKLAHOMA AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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2921THE BRIDGE HEALTH CLINICS & RESEARCH CENTERS
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201901/01/201808/19/2010
(414) 255-3451
(414) 831-4500toddcampbell@thebridgehealthclinicTODD CAMPBELL
County: MilwaukeeMILWAUKEE, WI 532185401 N 76TH STREET #100
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 07/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 07/31/2019THE BRIDGE HEALTH CLINICS & RC, INC. - BELOIT RD, 9401 BELOIT RD, SUITE 105, MILWAUKEE, WI
532271
2944THE POWER OF CHANGE INC BEHAVIORAL SERVICES
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201707/01/2011
(414) 374-8181
(414) [email protected] ARMON-BENT
County: MilwaukeeMILWAUKEE, WI 532122821 N 4TH STREET SUITE 131
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
1657UNITED COMMUNITY CENTER
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201605/01/1980
(414) 647-8602
(414) [email protected] A. RUIZ
County: MilwaukeeMILWAUKEE, WI 532041100 S 6TH STREET, 3RD FLOOR
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
2881UNITED COMMUNITY CENTER
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/13/2009
(414) 647-8602
(414) [email protected] A. RUIZ
County: MilwaukeeMILWAUKEE, WI 53204604 W SCOTT STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 08/01/2016 07/31/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2351UNITED COMMUNITY CENTER LATINAS UNIDAS
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201702/17/2014
(414) 647-8602
(414) [email protected] A. RUIZ
County: MilwaukeeMILWAUKEE, WI 532041123 SOUTH 6TH STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/01/2017 03/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
3167UNITED COMMUNITY CENTER-LATINAS UNIDAS 2
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201804/27/201704/27/2017
(414) 645-0165
(414) [email protected] RUIZ
County: MilwaukeeMILWAUKEE, WI 53204614 W SCOTT STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/27/2017 04/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 04/27/2017 04/30/2018
Services
NO BRANCH LOCATIONS
3150WCS-JOSHUA GLOVER RESIDENTIAL REENTRY CENTER
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201802/20/2017
(414) 239-7853
(414) [email protected] FITZSIMONS
County: MilwaukeeMILWAUKEE, WI 532102404 N 50TH STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
3053WCS-MILWAUKEE COUNTY DAY REPORTING CENTER
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201710/01/2014
(414) 342-8847
(414) [email protected] JUSSILA
County: MilwaukeeMILWAUKEE, WI 532083732 W WISCONSIN AVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
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2547WHEATON FRANCISCAN BEHAVIORAL HEALTH ST. FRANCIS HOSPITAL
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/27/2004
(414) 389-3110
(414) [email protected] HESS
County: MilwaukeeMILWAUKEE, WI 532153237 S 16TH STREET #310
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 11/01/2017 10/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 11/01/2017 10/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/20/2018 10/31/2019ASCENSION COLUMBIA ST MARYS AIRPORT, 4848 S 6TH ST, MILWAUKEE, WI 532211
11/01/2017 10/31/2019WHEATON FRANCISAN BEHAVIORAL HEALTH - FRANKLIN, 9969 S 27TH STREET, FRANKLIN, WI 53132
1
2548WHEATON FRANCISCAN BEHAVIORAL HEALTH ST. JOSEPH REGIONAL MEDICAL CTR
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/27/2004
(414) 874-1177
(414) [email protected] HESS
County: MilwaukeeMILWAUKEE, WI 532105000 W CHAMBERS ST #P210
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2004WILLOWGLEN ACADEMY OUTPATIENT CLINIC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/01/1992
(414) 527-6971
(414) [email protected] KUMMROW
County: MilwaukeeMILWAUKEE, WI 532164065 NORTH 35TH STREET STE # N100
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 07/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 08/01/2016 07/10/2017
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 08/01/2016 07/10/2017
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 07/31/2018WILLOWGLEN ACADEMY - DAY ONE EAST, 6414 W. FOND DU LAC AVE, MILWAUKEE, WI 532181
08/01/2016 07/31/2018WILLOWGLEN ACADEMY - CSP NORTH, 4941 W FOND DU LAC AVE, MILWAUKEE, WI 532162
08/01/2016 07/31/2018WILLOWGLEN ACADEMY, 5555 NORTH 51ST BLVD, MILWAUKEE, WI 532182
08/01/2016 07/31/2018WILLOWGLEN ACADEMY - ARROWHEAD UNION HS, 700 NORTH AVE, HARTLAND, WI 530293
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1955WISCONSIN COMMUNITY SERVICES UNLIMITED POTENTIALS
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201606/01/1986
(414) 226-0351
(414) [email protected] CARROLL
County: MilwaukeeMILWAUKEE, WI 532083732 W WISCONSIN AVE STE 200
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
1993WISCONSIN COMMUNITY SERVICES-COMMUNITY SUPPORT PROGRAM
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201611/01/1995
(414) 334-2191
(414) [email protected] COLLYARD
County: MilwaukeeMILWAUKEE, WI 532083734 W WISCONSIN AVENUE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
2509WORD OF HOPE MINISTRIES ATODA PROGRAM
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201803/01/2004
(414) 874-2826
(414) [email protected] FULLER
County: MilwaukeeMILWAUKEE, WI 532102677 N 40TH STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2018 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/28/2019
Services
NO BRANCH LOCATIONS
WAUWATOSA
1033ALTERNATIVES IN PSYCHOLOGICAL CONSULTATION, S.C.
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201711/20/1997
(414) 358-7158
(414) [email protected] DREXLER
County: MilwaukeeWAUWATOSA, WI 5322210045 W LISBON AVENUE, #221
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2019ALTERNATIVES IN PSYCH CONSULT, 6737 W WASHINGTON ST SUITE 1300, WEST ALLIS, WI 532142
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Substance Abuse Program Directory By County, City, and Provider Name
2518AURORA BEHAVIORAL HEALTH CENTER WAUWATOSA
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/31/2004
(414) 454-6450
(414) [email protected] MONSON DUPUIS
County: MilwaukeeWAUWATOSA, WI 532131220 DEWEY AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
1647AURORA PSYCHIATRIC HOSPITAL INC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201609/01/1979
(414) 454-6450
(414) [email protected] SURFUS-LEWISTON
County: MilwaukeeWAUWATOSA, WI 532131220 DEWEY AVENUE BLDG 4
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2017
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 08/01/2016 07/31/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 08/01/2016 07/31/2018
MENTAL HEALTH-INPATIENT DHS 61.71 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
3141AURORA PSYCHIATRIC HOSPITAL INC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/01/2016
(414) 454-6450
(414) [email protected] SURFUS LEWISTON
County: MilwaukeeWAUWATOSA, WI 532131220 DEWEY AVENUE BLDG 2
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
3142AURORA PSYCHIATRIC HOSPITAL INC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/01/2016
(414) 454-6450
(414) [email protected] SURFUS-LEWISTON
County: MilwaukeeWAUWATOSA, WI 532131220 DEWEY AVENUE BLDG 11
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1516LUTHERAN COUNSELING AND FAMILY SERVICES OF WISCONSIN
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201803/01/1978
(414) 536-8348
(414) [email protected] L RAYBURN
County: MilwaukeeWAUWATOSA, WI 532223800 N MAYFAIR ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020LCFS-ST JOHN LUTHERAN CHURCH, 4850 S LAKE DRIVE, CUDAHY, WI 531101
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 15 E SAWYER, RICE LAKE, WI 548681
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 168 MOUND STREET, BERLIN, WI 549231
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 210 S ONEIDA ST, GREEN BAY, WI 543031
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 2833 RARITAN, FITCHBURG, WI 537111
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 300 BROADWAY DR, SUN PRAIRIE, WI 535901
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 324 S ANDREWS ST, SHAWANO, WI 541661
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 345 NORTH PINE ST, REEDSBURG, WI 539591
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 717 MEMORIAL DRIVE, CHILTON, WI 530141
04/01/2018 03/31/2020LUTHERAN COUNSELING & FAMILY SERVICES OF WI, 850 ARMSTRONG ST, PORTAGE, WI 539011
Setting Begin/End DatesNon-Certified School Setting(s)04/01/2018 03/31/2020BEAUTIFUL SAVIOR LUTHERAN SCHOOL, 1205 EAST AVE, WAUKESHA, WI 53186
04/01/2018 03/31/2020GRACE LUTHERAN SCHOOL, N87W16173 KENWOOD BLVD, MENOMONEE FALLS, WI 53051
04/01/2018 03/31/2020OUR REDEEMER LUTHERAN SCHOOL, 10025 W NORTH AVE, WAUWATOSA, WI 53226
04/01/2018 03/31/2020RENAISSANCE LUTHERAN SCHOOL, 1510 VILLA ST, RACINE, WI 53403
04/01/2018 03/31/2020RENAISSANCE LUTHERAN SCHOOL, 6150 TAYLOR AVE, RACINE, WI 53403
04/01/2018 03/31/2020SHERMAN PARK, 88242 GRANVILLE RD, MILWAUKEE, WI 53210
2318WEST GROVE CLINIC
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201806/22/2001
(414) 810-4845
(414) [email protected] WEST
County: MilwaukeeWAUWATOSA, WI 5322210012 WEST CAPITOL DRIVE #101
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020WEST GROVE CLINIC LLC, 7310 W. WELLS ST., WAUWATOSA, WI 532132
WEST ALLIS
2397AURORA BEHAVIORAL HEALTH CENTER - WEST ALLIS
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201707/12/2002
(414) 454-6450
(414) [email protected] MONSON-DUPUIS
County: MilwaukeeWEST ALLIS, WI 532272424 S 90TH STREET SUITE 502
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
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2746IMPACT, ALCOHOL AND OTHER DRUG ABUSE SERVICE, INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/09/2007
(414) 771-4808
(414) [email protected] GUTIERREZ
County: MilwaukeeWEST ALLIS, WI 532146737 W WASHINGTON STREET, #2225
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 08/01/2016 07/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 07/31/2018IMPACT, ALCOHOL & OTHER DRUG ABUSE SERVICE, 3970 NORTH OAKLAND AVE, SHOREWOOD, WI
532111
2125MILWAUKEE CENTER FOR INDEPENDENCE DBA WHOLE HEALTH CLINICAL GROUP
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201709/01/1985
(414) 615-0627
(414) [email protected] CHIANELLI
County: MilwaukeeWEST ALLIS, WI 53214932 SOUTH 60TH STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
3032ROGERS MEMORIAL HOSPITAL
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201705/01/2014
(414) 882-7822
(414) [email protected] SCHULTZ
County: MilwaukeeWEST ALLIS, WI 532272448 SOUTH 102ND ST RM #200
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 05/01/2017 04/30/2019
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 05/01/2017 04/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2017 04/30/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/01/2017 04/30/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 05/01/2017 04/30/2019
MENTAL HEALTH-DAY TREATMENT WITH TELEHEALTH DHS 61.75 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2214ROGERS MEMORIAL HOSPITAL - MILWAUKEE
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201805/01/2000
(414) 327-6045
(414) [email protected] SCHULTZ
County: MilwaukeeWEST ALLIS, WI 5322711101 W. LINCOLN AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 05/01/2018 04/30/2020
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 05/01/2018 04/30/2020
MENTAL HEALTH-DAY TREAT/CHILDREN 2 W/TELEHEALTH DHS 40.11(2)(B) 05/01/2018 04/30/2020
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 2 DHS 40.11(2)(B) 05/01/2018 04/30/2020
MENTAL HEALTH-INPATIENT DHS 61.71 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
3172STEVANOVIC FAMILY CLINICS
Surveyor: William Rohner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201802/15/201702/15/2017
(414) 546-2909
(414) [email protected] STEVANOVIC
County: MilwaukeeWEST ALLIS, WI 5322711111 W OKLAHOMA AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 02/15/2017 01/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/15/2017 01/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/02/2017 01/31/2018
Services
NO BRANCH LOCATIONS
WEST MILWAUKEE
2236QUALITY ADDICTION MANAGEMENT, INC DBA WEST MILWAUKEE COMPREHENSIVE TREATMENT CTR
Surveyor: Merrilee Follensbee
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201606/19/2000
(414) 672-6026
(414) [email protected] BIZJAK
County: MilwaukeeWEST MILWAUKEE, WI 532141610 MILLER PARKWAY
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
MONROECASHTON
2804SCENIC BLUFFS COMMUNITY HEALTH CENTERS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/28/2008
(608) 654-5120
(608) [email protected] MLSNA
County: MonroeCASHTON, WI 54619238 FRONT STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020SCENIC BLUFFS COMMUNITY HEALTH CENTERS, 200 W. NORTH STREET, NORWALK, WI 546481
07/01/2018 06/30/2020SCENIC BLUFFS COMMUNITY HEALTH CENTERS, 217 N BLACK RIVER ST, RM 4, SPARTA, WI 546561
Setting Begin/End DatesNon-Certified School Setting(s)07/01/2018 06/30/2020CASHTON ELEMENTARY SCHOOL, 436 FRONT STREET, CASHTON, WI 54619
07/01/2018 06/30/2020CASHTON MIDDLE/HIGH SCHOOL, 540 COE STREET, CASHTON, WI 54619
07/01/2018 06/30/2020HIGH POINT CHARTER SCHOOL, 201 E FRANKLIN STREET, SPARTA, WI 54656
07/01/2018 06/30/2020S.A.I.L..S. CHARTER SCHOOL, 201 E FRANKLIN STREET, SPARTA, WI 54656
SPARTA
1654MONROE COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201812/01/201610/01/1975
(608) 269-8935
(608) [email protected] THORSEN
County: MonroeSPARTA, WI 5465614301 HWY B COMM SVS CTR A-19
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 12/01/2016 12/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 12/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 12/01/2016 12/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
OCONTOOCONTO
1719OCONTO COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201604/01/1979
(920) 834-6889
(920) [email protected] REIMER
County: OcontoOCONTO, WI 54153501 PARK AVENUE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 09/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
CSAS-PREVENTION DHS 75.04 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018NEW VIEW INDUSTRIES, 164 W PARK STREET, GILLETT, WI 541241
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Substance Abuse Program Directory By County, City, and Provider Name
ONEIDAMINOCQUA
3134FAMILY HEALTH CENTER OF MARSHFIELD, INC, MINOCQUA ALCOHOL & DRUG RECOVERY SVS
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201706/30/2016
(715) 358-1330
(715) [email protected] WEIX
County: OneidaMINOCQUA, WI 545489792 HIGHWAY 70 WEST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
RHINELANDER
1762ASCENSION ST MARY'S KOLLER BEHAVIORAL HEALTH
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201806/01/201606/01/1985
(715) 361-2920
(715) [email protected] SCHIEK
County: OneidaRHINELANDER, WI 545011020 KABEL AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2016 05/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/22/2017 05/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2016 05/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/22/2017 05/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier06/01/2016 05/31/2018ST MARYS HOSP MINISTRY/KOLLER CRANDON, 400 W GLEN STREET, CRANDON, WI 545201
06/01/2016 05/31/2018ST MARYS HOSP MINISTRY/KOLLER TOMAHAWK, 401 MOHAWK AVE, TOMAHAWK, WI 544871
06/01/2016 05/31/2018ST MARYS HOSP MINISTRY/KOLLER EAGLE RIVER, 930 E WALL STREET, EAGLE RIVER, WI 545212
06/01/2016 05/31/2018ST MARYS HOSP MINISTRY/KOLLER WOODRUFF, 240 MAPLE STREET, WOODRUFF, WI 545682
2977CORNERSTONE PSYCHOLOGICAL ASSOCIATES LLC
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201910/01/201708/14/2012
(715) 420-1202
(715) [email protected] F. MCGUIRE LPC
County: OneidaRHINELANDER, WI 54501315 S ONEIDA AVE SUITE 101
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3196HARMONY COUNSELING SERVICES LLC DBA TRANSITIONS CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/24/201801/24/2018
(715) 365-6768
(715) [email protected] WEGE
County: OneidaRHINELANDER, WI 5450122 N PELHAM ST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/24/2018 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/24/2018 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/24/2018 12/31/2018NICOLET COLLEGE, 5364 COLLEGE DRIVE, RHINELANDER, WI 545011
01/24/2018 12/31/2018PHELPS, 4451 OLD SCHOOL RD, PHELPS, WI 545543
1469KOINONIA OPTIONS COUNSELING SERVICES LLC
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201610/01/1986
(715) 362-2819
(715) [email protected] DECORAH
County: OneidaRHINELANDER, WI 545011991 WINNEBAGO STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 12/01/2016 11/30/2018
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 12/01/2016 11/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2742OPTIONS COUNSELING SERVICES LLC
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/17/2007
(715) 362-2819
(715) [email protected] DECORAH
County: OneidaRHINELANDER, WI 54501158 SOUTH ANDERSON ST SUITE 1
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020KOINONIA, 1991 WINNEBAGO STREET, RHINELANDER, WI 545011
04/01/2018 03/31/2020CENTRAL ELEMENTARY, 418 NORTH PELHAM STREET, RHINELANDER, WI 545013
04/01/2018 03/31/2020CRANDON ELEMENTARY/ MIDDLE/HIGH SCHOOL, 9750 US HWY 8 WEST, CRANDON, WI 545203
04/01/2018 03/31/2020CRESCENT ELEMENTARY, 3319 BOYCE DRIVE, RHINELANDER, WI 545013
04/01/2018 03/31/2020EAGLE RIVER ELEMENTARY SCHOOL, 1700 PLEASURE ISLAND RD, EAGLE RIVER, WI 545213
04/01/2018 03/31/2020JAMES WILLIAMS MIDDLE SCHOOL, 915 ACACIA LANE, RHINELANDER, WI 545013
04/01/2018 03/31/2020LAND O' LAKES ELEMENTARY, 6485 TOWN HALL ROAD, LAND O LAKES, WI 545403
04/01/2018 03/31/2020NORTH ELEMEMTARY, 506 GRAHAM AVE, ANTIGO, WI 544093
04/01/2018 03/31/2020NORTH LAKELAND SCHOOL DISTRICT, 12686 COUNTY HIGHWAY K, MANITOWISH WATERS, WI 54545
3
04/01/2018 03/31/2020NORTHERN ACHIEVEMENT CENTER, 215 DIVISION STREET, EAGLE RIVER, WI 545213
04/01/2018 03/31/2020NORTHLAND PINES HIGH SCHOOL, 1800 PLEASURE ISLAND ROAD, EAGLE RIVER, WI 545213
04/01/2018 03/31/2020NORTHLAND PINES MIDDLE SCHOOL, 1700 PLEASURE ISLAND RD, EAGLE RIVER, WI 545213
04/01/2018 03/31/2020NORTHWOODS COMM. SECONDARY CHARTER SCHOOL, 665 COOLIDGE AVENUE, RHINELANDER, WI 54501
3
04/01/2018 03/31/2020NORTHWOODS COMMUNITY ELEMENTARY CHARTER SCHOOL, 9086 COUNTY HWY K, HARSHAW, WI 54529
3
04/01/2018 03/31/2020PELICAN ELEMENTARY, 3350 V HICKEY ROAD, RHINELANDER, WI 545013
04/01/2018 03/31/2020RHINELANDER HIGH SCHOOL, 665 COOLIDGE, RHINELANDER, WI 545013
04/01/2018 03/31/2020SOAR CHARTER SCHOOL, 6485 TOWN HALL RD, LAND O LAKES, WI 545403
04/01/2018 03/31/2020ST GERMAIN ELEMENTARY SCHOOL, 8234 HWY 70 WEST, SAINT GERMAIN, WI 545583
1427THE HUMAN SERVICE CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201609/01/1980
(715) 369-2214
(715) [email protected] SHIMECK
County: OneidaRHINELANDER, WI 54501705 EAST TIMBER DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 10/01/2016 09/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3043THE HUMAN SERVICE CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201806/27/2014
(715) 369-2214
(715) [email protected] SHIMECK
County: OneidaRHINELANDER, WI 54501705 EAST TIMBER DRIVE
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL UNIFIED BOARD DHS 36 07/01/2018 06/30/2020
CCS REGIONAL MODEL UNIFIED BOARD W/TELEHEALTH DHS 36 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
1426THE HUMAN SERVICE CENTER CSP
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201809/01/1980
(715) 369-2214
(715) [email protected] SHIMECK
County: OneidaRHINELANDER, WI 54501705 E. TIMBER DRIVE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 06/01/2018 05/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 06/01/2018 05/31/2019
Services
NO BRANCH LOCATIONS
2642TRANSITIONS CENTER, LLC
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201804/01/201702/01/2006
(715) 365-6768
(715) [email protected] MARTIN
County: OneidaRHINELANDER, WI 5450122 N PELHAM STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 01/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 01/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier05/30/2017 01/31/2018TRANSITIONS NICOLET, RED OAK CENTER - ROOM 207A NICOLET COLLEGE, RHINELANDER, WI
545011
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Substance Abuse Program Directory By County, City, and Provider Name
OUTAGAMIEAPPLETON
2608ACS CLINICAL SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/2005
(920) 830-1770
(920) [email protected] MANN
County: OutagamieAPPLETON, WI 54912720 W WASHINGTON STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018ACS CLINICAL SERVICES - MANITOWOC, 33 E WALDO BLVD, MANITOWOC, WI 542202
3017ACS CLINICAL SERVICES, LLC - APPLETON CRP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/16/2015
(920) 840-6445
(920) [email protected] MANN
County: OutagamieAPPLETON, WI 549152 BRIGHTON CIRCLE
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
1130CASA CLARE, A DIVISION OF MOORING PROGRAMS, INC.
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201703/21/1996
(920) 731-2853
(920) [email protected] VERVOORT
County: OutagamieAPPLETON, WI 54914201 S GLENRIDGE COURT
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 04/01/2017 03/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 04/01/2017 03/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2984CATALPA HEALTH INC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/01/2012
(920) 882-5495
(920) [email protected] RADKE
County: OutagamieAPPLETON, WI 54914444 NORTH WESTHILL BLVD
Service Begin/End DatesAdm Code
CSAS-PREVENTION DHS 75.04 11/01/2017 10/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2017 10/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2017 10/31/2019BOYS AND GIRLS CLUB OF OSHKOSH, 501 E PARKWAY AVENUE, OSHKOSH, WI 549011
11/01/2017 10/31/2019CATALPA HEALTH - CASALOMA CAMPUS, 1920 N CASALOMA ST, APPLETON, WI 549132
11/01/2017 10/31/2019CATALPA HEALTH - WAUPACA, 825 WEST FULTON ST, WAUPACA, WI 549812
11/01/2017 10/31/2019CATALPA HEALTH ACCESS CENTER, 442 WESTHILL BLVD., APPLETON, WI 549142
11/01/2017 10/31/2019CATALPA HEALTH, 540 N KOELLER ST, OSHKOSH, WI 549022
11/01/2017 10/31/2019BLACK CREEK ELEMENTARY & MIDDLE SCHOOLS, 308 EAST BURDICK ST, BLACK CREEK, WI 541063
11/01/2017 10/31/2019CHILTON HIGH SCHOOL, 530 W MAIN ST, CHILTON, WI 530143
11/01/2017 10/31/2019CLAYTON ELEMENTARY SCHOOL, 2916 WEST FAIRVIEW ROAD, NEENAH, WI 549563
11/01/2017 10/31/2019COOLIDGE ELEMENTARY SCHOOL, 321 ALCOTT DRIVE, NEENAH, WI 549563
11/01/2017 10/31/2019FREEDOM ELEMENTARY SCHOOL, N3569 COUNTY ROAD E, FREEDOM, WI 541313
11/01/2017 10/31/2019FREEDOM HIGH & MIDDLE SCHOOLS, N4021 COUNTY ROAD E, FREEDOM, WI 541313
11/01/2017 10/31/2019GREENVILLE ELEMENTARY SCHOOL, W6822 GREENRIDGE DR., GREENVILLE, WI 549423
11/01/2017 10/31/2019GREENVILLE MIDDLE SCHOOL, N1450 FAWN RIDGE DR., GREENVILLE, WI 549423
11/01/2017 10/31/2019HOOVER ELEMENTARY SCHOOL, 950 HUNT AVENUE, NEENAH, WI 549563
11/01/2017 10/31/2019HORIZON ELEMENTARY SCHOOL, 2101 SCHAEFER CIRCLE, APPLETON, WI 549153
11/01/2017 10/31/2019HORTONVILLE ELEMENTARY SCHOOL, 240 WARNER ST., HORTONVILLE, WI 549443
11/01/2017 10/31/2019HORTONVILLE HIGH SCHOOL, 155 WARNER ST; PO BOX 220, HORTONVILLE, WI 549443
11/01/2017 10/31/2019HORTONVILLE MIDDLE SCHOOL, 220 WARNER ST; PO BOX 359, HORTONVILLE, WI 549443
11/01/2017 10/31/2019LAKEVIEW ELEMENTARY SCHOOL, 1645 S. COMMERCIAL ST., NEENAH, WI 549563
11/01/2017 10/31/2019MADISON MIDDLE SCHOOL, 2020 S. CARPENTER STREET, APPLETON, WI 549153
11/01/2017 10/31/2019MENASHA HIGH SCHOOL, 420 SEVENTH STREET, MENASHA, WI 549523
11/01/2017 10/31/2019MERRILL MIDDLE SCHOOL, 108 W NEW YORK AVE, OSHKOSH, WI 549013
11/01/2017 10/31/2019NORTH GREENVILLE ELEMENTARY SCHOOL, N2468 LEARNING WAY, GREENVILLE, WI 549423
11/01/2017 10/31/2019OSHKOSH NORTH HIGH SCHOOL, 1100 W. SMITH AVE., OSHKOSH, WI 549013
11/01/2017 10/31/2019OSHKOSH NORTH HIGH SCHOOL, 375 N EAGLE ST, OSHKOSH, WI 549023
11/01/2017 10/31/2019READ ELEMENTARY SCHOOL, 1120 ALGOMA BLVD, OSHKOSH, WI 549013
11/01/2017 10/31/2019ROCKLEDGE PRIMARY/INTERMEDIATE CENTERS, 330 WEST HICKORY ST, SEYMOUR, WI 541653
11/01/2017 10/31/2019ROOSEVELT ELEMENTARY SCHOOL, 1645 S COMMERCIAL STREET, NEENAH, WI 549563
11/01/2017 10/31/2019ROOSEVELT MIDDLE SCHOOL, 318 EAST BREWSTER ST, APPLETON, WI 549113
11/01/2017 10/31/2019SHIOCTON PUBLIC SCHOOLS, N5650 BROAD ST, SHIOCTON, WI 541703
11/01/2017 10/31/2019SPRING ROAD ELEMENTARY SCHOOL, 1191 COUNTY ROAD II, NEENAH, WI 549563
11/01/2017 10/31/2019TAFT ELEMENTARY SCHOOL, 133 WESTERN AVENUE, NEENAH, WI 549563
11/01/2017 10/31/2019TULLAR ELEMENTARY SCHOOL, 925 TULLAR ROAD, NEENAH, WI 549563
11/01/2017 10/31/2019WASHINGTON ELEMENTARY SCHOOL, 929 WINNEBAGO AVE, OSHKOSH, WI 549013
11/01/2017 10/31/2019WAUPACA HIGH SCHOOL, E2325 KING ROAD, WAUPACA, WI 549813
11/01/2017 10/31/2019WAUPACA LEARNING CENTER ELEMENTARY SCHOOL, 1515 SHOEMAKER ROAD, WAUPACA, WI 54981
3
11/01/2017 10/31/2019WAUPACA MIDDLE SCHOOL, 1149 SHOEMAKER ROAD, WAUPACA, WI 549813
11/01/2017 10/31/2019WEBSTER STANLEY MIDDLE SCHOOL, 915 HAZEL STREET, OSHKOSH, WI 549013
11/01/2017 10/31/2019WILSON ELEMENTARY SCHOOL, 920 HIGGINS AVENUE, NEENAH, WI 549563
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Substance Abuse Program Directory By County, City, and Provider Name
2872LUTHERAN SOCIAL SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201706/02/2009
(920) 734-2824
(920) [email protected] MITCHELL
County: OutagamieAPPLETON, WI 549113003 B NORTH RICHMOND ST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2017 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2018LUTHERAN SOCIAL SERVICES, 1850 CRANSTON ROAD, BELOIT, WI 535111
09/01/2017 08/31/2018LUTHERAN SOCIAL SERVICES, 612 N RANDALL STREET, JANESVILLE, WI 535452
09/01/2017 08/31/2018LUTHERAN SOCIAL SERVICES, 6314 ODANA ROAD, MADISON, WI 537192
Setting Begin/End DatesNon-Certified School Setting(s)09/01/2017 08/31/2018LSS-APPLETON EAST HIGH SCHOOL, 2121 E EMMERS DR, APPLETON, WI 54915
09/01/2017 08/31/2018LSS-CLOVIS GROVE ELEMENTARY SCHOOL, 974 NINTH STREET, MENASHA, WI 54952
09/01/2017 08/31/2018LSS-FRANKLIN ELEMENTARY SCHOOL, 800 S 35TH STREET, MANITOWOC, WI 54220
09/01/2017 08/31/2018LSS-HEAD START-CAPITOL, 5310 W CAPITOL DR, MILWAUKEE, WI 53216
09/01/2017 08/31/2018LSS-IDEAS ACADEMY, 830 VIRGINIA AVE, SHEBOYGAN, WI 53081
09/01/2017 08/31/2018LSS-LB CLARKE MIDDLE SCHOOL, 4608 BELLEVUE PLACE, TWO RIVERS, WI 54241
09/01/2017 08/31/2018LSS-PLYMOUTH HIGH SCHOOL, 125 S HIGHLAND AVE, PLYMOUTH, WI 53073
09/01/2017 08/31/2018LSS-RANDOM LAKE ELEMENTARY SCHOOL, 605 RANDOM LAKE ROAD, RANDOM LAKE, WI 53075
1962MILWAUKEE HEALTH SERVICES SYSTEM, LLC DBA APPLETON COMPREHENSIVE TREATMENT CTR
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201607/09/1990
(920) 733-4796
(920) [email protected] WILLIQUETTE
County: OutagamieAPPLETON, WI 549113301 N BALLARD RD SUITE B
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
1917MOORING PROGRAMS, INC.
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201805/08/1991
(920) 731-4796
(920) [email protected] VERVOORT
County: OutagamieAPPLETON, WI 54911607 W. SEVENTH STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 07/01/2018 06/30/2020
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 07/01/2018 06/30/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2512OPTIONS TREATMENT PROGRAMS INC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/01/2004
(920) 735-9010
(920) [email protected] HAGEN
County: OutagamieAPPLETON, WI 549141000 N LYNNDALE DRIVE STE C
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2018 03/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2018 03/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier04/01/2018 03/31/2020OPTIONS TREATMENT PROGRAMS, INC., 424 S MONROE AVE #201, GREEN BAY, WI 543012
04/01/2018 03/31/2020OPTIONS TREATMENT PROGRAMS, INC., 922 CHURCHILL ST, WAUPACA, WI 549812
04/01/2018 03/31/2020OPTIONS TREATMENT PROGRAMS-OSHKOSH, 502 E. NEW YORK AVE., OSHKOSH, WI 549012
2314OUTAGAMIE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/1987
(920) 832-5488
(920) [email protected] MARMOR
County: OutagamieAPPLETON, WI 54911320 S WALNUT ST
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
2590OUTAGAMIE CTY HEALTH AND HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/01/2005
(920) 832-5488
(920) [email protected] VAN RYZIN
County: OutagamieAPPLETON, WI 54911401 S ELM STREET
CCS Affiliaton: 09/01/2014Begin: End: Lead:Northeastern Region CCS Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
1860ST. ELIZABETH HOSPITAL
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201702/01/1984
(920) 730-5480
(920) [email protected] REICH
County: OutagamieAPPLETON, WI 549151506 S. ONEIDA STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 11/01/2017 10/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2017 10/31/2019
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 11/01/2017 10/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
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1997WISCONSIN LUTHERAN CHILD & FAMILY SERVICE, INC DBA CHRISTIAN FAMILY SOLUTIONS
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201605/01/1990
(262) 345-5531
(262) [email protected] SEMMANN
County: OutagamieAPPLETON, WI 549144351 WEST COLLEGE AVE #410
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2016 08/31/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 07/13/2017 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018WLCFS - CHRISTIAN FAMILY SOLUTIONS, 757 S MAIN ST, STE 8, FOND DU LAC, WI 549352
09/01/2016 08/31/2018FOX VALLEY LUTHERAN HS, 5300 N MEADE ST, APPLETON, WI 549133
09/01/2016 08/31/2018NORTHLAND LUTHERAN HS, 2107 TOWER ROAD, MOSINEE, WI 544553
09/01/2016 08/31/2018WINNEBAGO LUTHERAN ACADEMY, 475 E MERRILL AVE, FOND DU LAC, WI 549353
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Substance Abuse Program Directory By County, City, and Provider Name
OZAUKEECEDARBURG
1695NORTHSHORE CLINIC & CONSULTANTS, INC.
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201710/01/1987
(262) 375-1071
(262) [email protected] MYERS
County: OzaukeeCEDARBURG, WI 53012W62 N248 WASHINGTON AVE., #207
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 11/30/2017
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2017 07/31/2019NORTHSHORE CLINIC & CONSULTANTS, 207 E BUFFALO STREET, #510, MILWAUKEE, WI 532021
08/01/2017 07/31/2019NORTHSHORE CLINIC & CONSULTANTS, 2363 S 102ND STREET, #203, WEST ALLIS, WI 532272
08/01/2017 07/31/2019NORTHSHORE CLINIC & CONSULTANTS, INC., 1615 BARTON AVENUE, WEST BEND, WI 530902
GRAFTON
3009ALARUS HEALTHCARE, LLC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201610/08/2013
(262) 377-6289
(262) [email protected] J. OWEN
County: OzaukeeGRAFTON, WI 530241971 WASHINGTON ST SUITE 200
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2016 09/30/2018ALARUS HEALTHCARE - BEAVER DAM, 111 WARREN ST #2, BEAVER DAM, WI 539162
10/01/2016 09/30/2018ALARUS HEALTHCARE - WEST BEND, 1622 CHESTNUT ST., WEST BEND, WI 530952
MEQUON
3176ACHIEVEMENT ASSOCIATES CENTER INC
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201709/01/2017
(262) 241-5054
(262) [email protected] FREEMAN
County: OzaukeeMEQUON, WI 530921317 TOWNE SQUARE RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2017 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2018ACHIEVEMENT ASSOCIATES CENTER INC, 2600 N MAYFAIR ROAD, MILWAUKEE, WI 532262
09/01/2017 08/31/2018ACHIEVEMENT ASSOCIATES CENTER INC, 5228 W FOND DU LAC AVE, MILWAUKEE, WI 532162
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Substance Abuse Program Directory By County, City, and Provider Name
2368AMERICAN BEHAVIORAL CLINICS
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202007/01/201805/01/2002
(262) 241-4311
(262) [email protected] SCHRINSKY
County: OzaukeeMEQUON, WI 530921240 W RANCHITO LANE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 05/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 05/31/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 05/31/2020AMERICAN BEHAVIORAL CLINICS-BLUEMOUND #2, 9720 W BLUEMOUND ROAD, MILWAUKEE, WI
532261
07/01/2018 05/31/2020AMERICAN BEHAVIORAL CLINICS-BLUEMOUND #1, 10424 W BLUEMOUND ROAD, MILWAUKEE, WI 53226
2
07/01/2018 05/31/2020AMERICAN BEHAVIORAL CLINICS-ELM GROVE, 15285 WATERTOWN PLANK ROAD, ELM GROVE, WI 53122
2
07/01/2018 05/31/2020AMERICAN BEHAVIORAL CLINICS-LAYTON, 7330 W LAYTON AVENUE, MILWAUKEE, WI 532202
2507COLUMBIA ST MARY'S BEHAVIORAL MEDICINE-MEQUON
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201809/02/2003
(262) 241-6132
(262) [email protected] MCGLYNN
County: OzaukeeMEQUON, WI 5309713111 N PORT WASHINGTON ROAD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2018 02/29/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
MENTAL HEALTH-DAY TREATMENT DHS 61.75 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
1873COLUMBIA ST. MARY'S OZAUKEE HOSPITAL BEHAVIORAL HEALTH UNIT
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201809/01/1984
(262) 243-8380
(414) [email protected] MCGLYNN
County: OzaukeeMEQUON, WI 5309713111 N PORT WASHINGTON RD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 03/01/2018 02/29/2020
MENTAL HEALTH-INPATIENT DHS 61.71 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
PORT WASHINGTON
1276DEPARTMENT OF COMMUNITY PROGRAMS-OZAUKEE COUNTY
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201606/01/1977
(262) 238-8104
(262) [email protected] CARLSON
County: OzaukeePORT WASHINGTON, WI 53074121 W. MAIN STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2274DEPARTMENT OF COMMUNITY PROGRAMS-OZAUKEE COUNTY CSP
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201706/01/1977
(262) 238-8104
(262) [email protected] DRAKE
County: OzaukeePORT WASHINGTON, WI 53074121 W. MAIN STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
3050OZAUKEE COUNTY CCS PROGRAM
Surveyor: Demetrius Anderson
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201609/22/2014
(262) 284-8104
(262) [email protected] CARLSON
County: OzaukeePORT WASHINGTON, WI 53074121 W MAIN STREET
CCS Affiliaton: 01/01/2015Begin: End: Lead:Lakeshore Recovery Collaborative
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
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PIERCEELLSWORTH
1737PIERCE COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201712/01/1981
(715) 273-6862
(715) [email protected] KIESLER
County: PierceELLSWORTH, WI 54011412 W KINNE STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
3020PIERCE COUNTY DEPT OF HUMAN SVS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/01/2014
(715) 273-6862
(715) [email protected] KIESLER
County: PierceELLSWORTH, WI 54011412 WEST KINNE STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
RIVER FALLS
1468KINNIC FALLS ALCOHOL AND DRUG ABUSE SERVICES INC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201705/01/1990
(715) 426-5763
(715) [email protected] IHUS
County: PierceRIVER FALLS, WI 54022900 S ORANGE STREET
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
POLKAMERY
2839AMERY REGIONAL MEDICAL CENTER BEHAVIORAL HEALTH CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201712/08/2008
(715) 268-0061
(715) 268-0060Heather.E.Erickson@AmerymedicalHEATHER ERICKSON
County: PolkAMERY, WI 54001230 DERONDA STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/04/2018 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
MENTAL HEALTH-INPATIENT DHS 61.71 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2019CLEAR LAKE CLINIC, 357 THIRD AVENUE, CLEAR LAKE, WI 540051
01/08/2018 11/30/2019LUCK CLINIC, AMERY HOSPITAL AND CLINIC, 2547 SATE ROAD 35, SUITE 1, LUCK, WI 548531
12/01/2017 11/30/2019TURTLE LAKE CLINIC, 550 MARTIN AVENUE, TURTLE LAKE, WI 548891
BALSAM LAKE
2222POLK COUNTY BEHAVIORAL HEALTH DEPARTMENT CSP
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201801/26/2000
(715) 485-8450
(715) [email protected] LAVASSEUR
County: PolkBALSAM LAKE, WI 54810100 POLK CO PLAZA #50
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
2204POLK COUNTY BEHAVIORAL HEALTH DEPT
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201802/08/2000
(715) 485-8490
(715) [email protected] LAVASSEUR
County: PolkBALSAM LAKE, WI 54810100 POLK COUNTY PLAZA #50
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
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PORTAGEPLOVER
2566OSWALD COUNSELING ASSOCIATES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/202001/01/201801/14/2005
(715) 342-0291
(715) [email protected] OSWALD
County: PortagePLOVER, WI 544672450 VINEYARD DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2020
Services
NO BRANCH LOCATIONS
STEVENS POINT
1216ASCENSION ST MICHAELS BEHAVIORAL HEALTH
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201909/01/201710/01/1990
(715) 345-0223
(715) [email protected] ROBERTS
County: PortageSTEVENS POINT, WI 54481201 PRENTICE STREET NORTH
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 09/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
1217ASCENSION ST MICHAELS BEHAVIORAL HEALTH
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201909/01/201705/01/1991
(715) 344-8127
(715) [email protected] ROBERTS
County: PortageSTEVENS POINT, WI 54481209 PRENTICE STREET NORTH
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 06/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 06/30/2019ASCENSION ST MICHAELS BEHAVIORAL HEALTH, 190 GRAND SEASONS DR, WAUPACA, WI 549812
1820ASCENSION ST MICHAELS BEHAVIORAL HEALTH
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201705/01/1978
(715) 346-5571
(715) [email protected] ROBERTS
County: PortageSTEVENS POINT, WI 54481900 ILLINOIS AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 10/01/2017 09/30/2019
MENTAL HEALTH-INPATIENT DHS 61.71 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
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1740PORTAGE COUNTY HEALTH & HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201706/01/1976
(715) 345-5966
(715) [email protected] MARCOTT
County: PortageSTEVENS POINT, WI 54481817 WHITING AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 04/01/2017 03/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
2712PORTAGE COUNTY HEALTH & HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/2007
(715) 345-5966
(715) [email protected] MARCOTT
County: PortageSTEVENS POINT, WI 54481817 WHITING AVENUE
CCS Affiliaton: 09/01/2014Begin: End: Lead:Portage Wood Partnership
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
2230RIVERWOOD COUNSELING ASSOCIATES LLC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/17/2000
(715) 343-5899
(715) [email protected] A MILLER
County: PortageSTEVENS POINT, WI 544811052 MAIN STREET, #202
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
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PRICEPHILLIPS
1244COUNSELING AND DEVELOPMENT CENTER, INC.
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201708/01/1982
(715) 339-2436
(715) [email protected] ENGFER
County: PricePHILLIPS, WI 54555171 CHESTNUT STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2017 07/31/2018COUNSELING & DEVELOPMENT CENTER, 170 N 4TH AVE, PARK FALLS, WI 545521
2053COUNSELING AND DEVELOPMENT CENTER, INC. COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201711/01/201508/01/1998
(715) 339-2436
(715) [email protected] ENGFER
County: PricePHILLIPS, WI 54555171 CHESTNUT STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 11/01/2015 10/31/2017
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2015 10/31/2017
Services
NO BRANCH LOCATIONS
3131NEW HORIZONS NORTH COMMUNITY SUPPORT PROGRAM PRICE COUNTY
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/28/2016
(715) 682-7176
(715) [email protected] LEVNO
County: PricePHILLIPS, WI 545551215 N AIRPORT RD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
RACINEBURLINGTON
1022AGAPE RECOVERY CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/01/1994
(262) 767-9072
(262) [email protected] A GRAMKE
County: RacineBURLINGTON, WI 53105201 N PINE ST
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
RACINE
2976BEHAVIORAL HEALTH SERVICES OF RACINE COUNTY
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/02/2012
(262) 638-6540
(262) [email protected] GOGGINS
County: RacineRACINE, WI 534031717 TAYLOR AVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 11/17/2017 07/31/2019
CSAS-PREVENTION DHS 75.04 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2017 07/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 11/17/2017 07/31/2019
Services
NO BRANCH LOCATIONS
1339FAMILY SERVICE OF RACINE, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201711/01/1983
(262) 634-5342
(262) [email protected] HANSON WILL
County: RacineRACINE, WI 53403420 SEVENTH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/10/2017 04/20/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
2730GBS LAUREL HOUSE
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/25/201804/09/2007
(262) 633-5626
(414) [email protected] SANCHEZ
County: RacineRACINE, WI 534041725 SPRING PLACE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 05/25/2018 04/30/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 05/25/2018 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2777GENESIS BEHAVIORAL SERVICES, INC. CHATHAM HOUSE
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/2008
(262) 637-2620
(414) [email protected] SANCHEZ
County: RacineRACINE, WI 534021636 CHATHAM STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 03/01/2017 02/28/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
1380GENESIS BEHAVIORAL SERVICES, INC. CROSSROADS
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/01/1994
(262) 633-5626
(414) [email protected] SANCHEZ
County: RacineRACINE, WI 534024107-4109 ST CLAIR STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 09/01/2017 08/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
2341QUALITY ADDICTION MANAGEMENT, INC DBA RACINE COMPREHENSIVE TREATMENT CTR
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201611/12/2001
(262) 598-1395
(262) [email protected] RODRIGUEZ
County: RacineRACINE, WI 534065735 DURAND AVENUE
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
3031RACINE COUNTY CCS
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201705/08/2014
(262) 638-6857
(262) [email protected] GOGGINS
County: RacineRACINE, WI 534031717 TAYLOR AVE
CCS Affiliaton: 12/01/2014Begin: End: Lead:Kenosha Racine Regional Consortium (KRRC)
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 06/01/2017 05/31/2019
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 11/17/2017 05/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2490RACINE COUNTY HUMAN SERVICES DEPARTMENT
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/14/2004
(262) 638-6983
(262) [email protected] GOGGINS
County: RacineRACINE, WI 534031717 TAYLOR AVENUE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 01/01/2017 12/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
2952RACINE COUNTY HUMAN SERVICES DEPARTMENT COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/2011
(262) 638-6983
(262) [email protected] GOGGINS
County: RacineRACINE, WI 534031717 TAYLOR AVENUE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
1027WHEATON FRANCISCAN HEALTHCARE ALL SAINTS MENTAL HEALTH & ADDICTION CARE
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/1990
(262) 687-2802
(262) [email protected] NIELSEN
County: RacineRACINE, WI 534031320 WISCONSIN AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2018 06/30/2020
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 07/01/2018 06/30/2020
MENTAL HEALTH-DAY TREATMENT DHS 61.75 07/01/2018 06/30/2020
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 2 DHS 40.11(2)(B) 07/01/2018 06/30/2020
MENTAL HEALTH-INPATIENT DHS 61.71 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS, 2408 FOUR MILE ROAD, RACINE, WI 534022
07/01/2018 06/30/2020WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS, 3805B SPRING ST #240, RACINE, WI 534022
07/01/2018 06/30/2020WHEATON FRANCISCAN HEALTHCARE-SPRING STREET CAMPUS, 3821 SPRING ST, RACINE, WI 53405
2
07/01/2018 06/30/2020WHEATON FRANCISCAN HLTHCARE ALL SAINTS STURTEVANT, 10340 WASHINGTON AVENUE, STURTEVANT, WI 53177
2
07/01/2018 06/30/2020WHEATON FRANCISCAN MED GRP - FAMILY MED CLINIC, 3807 SPRING ST #3063A, RACINE, WI 53405
2
07/01/2018 06/30/2020WHEATON FRANCISCAN MED GRP-CENTER FOR ADDICTION, 3805 B SPRING ST LL-20, RACINE, WI 53403
2
07/01/2018 06/30/2020WHEATON FRANCISCAN MEDICAL GROUP - NEUROLOGY, 3805 B SPRING ST 3RD FLOOR, RACINE, WI 53405
2
07/01/2018 06/30/2020WHEATON FRANCISCAN MEDICAL GROUP - UNION GROVE, 1120 MAIN ST, UNION GROVE, WI 531822
07/01/2018 06/30/2020WHEATON FRANCISCAN MEDICAL GROUP, 8020 S HOWELL AVE, OAK CREEK, WI 531542
07/01/2018 06/30/2020WHEATON FRANCISCAN MEDICAL GROUP-ALL SAINTS, 4328 OLD GREEN BAY ROAD, MOUNT PLEASANT, WI 53403
2
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Substance Abuse Program Directory By County, City, and Provider Name
RICHLANDRICHLAND CENTER
1797RICHLAND COUNTY HEALTH & HUMAN SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201801/01/1988
(608) 647-6611
(608) [email protected] CULVER
County: RichlandRICHLAND CENTER, WI 53581221 W SEMINARY STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 02/01/2018 01/31/2020
CSAS-EMERGENCY OUTPATIENT WITH TELEHEALTH DHS 75.05 02/01/2018 01/31/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2018 01/31/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 02/01/2018 01/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2018 01/31/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 02/01/2018 01/31/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 02/01/2018 01/31/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
2563RICHLAND COUNTY HEALTH AND HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201801/01/2005
(608) 647-6611
(608) [email protected] CULVER
County: RichlandRICHLAND CENTER, WI 53581221 W SEMINARY STREET
CCS Affiliaton: 07/01/2014Begin: End: Lead:Wisconsin River CCS Collaboration
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
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ROCKBELOIT
1100BELOIT MEMORIAL HOSPITAL-COUNSELING CARE CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201607/01/1985
(608) 363-5756
(608) [email protected] NEECE
County: RockBELOIT, WI 535111969 W HART ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2016 11/30/2018BELOIT HEALTH SYSTEM, CANCER CENTER, 1670 LEE LANE, BELOIT, WI 535111
12/01/2016 11/30/2018JANESVILLE OCCUPATIONAL HEALTH, 1409 B CRESTON PARK MALL DRIVE, JANESVILLE, WI 535451
12/01/2016 11/30/2018BELOIT MEMORIAL HIGH SCHOOL, 1225 4TH STREET, BELOIT, WI 535113
2686QUALITY ADDICTION MANAGEMENT, INC DBA BELOIT COMPREHENSIVE TREATMENT CTR
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201610/06/2006
(608) 361-7201
(608) [email protected] RHODES
County: RockBELOIT, WI 535112240 PRAIRIE AVENUE #10
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
1804ROCK COUNTY HUMAN SERVICES DEPARTMENT - BELOIT COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201709/01/1989
(608) 363-6392
(608) [email protected] COTTINGTON
County: RockBELOIT, WI 5351164 ECLIPSE CENTER
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
JANESVILLE
1809COMPASS BEHAVIORAL HEALTH CLINIC, A DIVISION OF RVCP
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/01/1990
(608) 741-4502
(608) [email protected] EGGERS
County: RockJANESVILLE, WI 53546203 W SUNNY LANE ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2018 02/29/2020COMPASS JANESVILLE CLINIC, 1820 CENTER AVE #170, JANESVILLE, WI 535462
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Substance Abuse Program Directory By County, City, and Provider Name
1381GENESIS COUNSELING SERVICES LTD
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/1988
(608) 757-2319
(608) [email protected] BURNS
County: RockJANESVILLE, WI 53545ONE S MAIN STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
3126JANESVILLE MOBILIZING 4 CHANGE
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201911/01/201706/08/2016
(608) 741-2105janesvillemobilizing4change@gmailERIN DAVIS
County: RockJANESVILLE, WI 53545ONE PARKER PLACE, STE 308
Service Begin/End DatesAdm Code
CSAS-PREVENTION DHS 75.04 11/01/2017 05/31/2019
Services
NO BRANCH LOCATIONS
3002MERCY HEALTH SYSTEM - MERCY OPTIONS WINGS PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201705/18/2013
(608) 756-6564
(608) [email protected] USGAARD
County: RockJANESVILLE, WI 53548903 MINERAL POINT AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
1612MERCY OPTIONS - MERCY HEALTH SYSTEMS
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201710/01/1984
(608) 756-6564
(608) [email protected] USGAARD
County: RockJANESVILLE, WI 535481000 MINERAL POINT AVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 07/01/2017 06/30/2019
MENTAL HEALTH-INPATIENT DHS 61.71 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
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1610MERCY OPTIONS BEHAVIORAL HEALTH CLINIC JANESVILLE
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/1993
(608) 756-0174
(608) [email protected] USGAARD
County: RockJANESVILLE, WI 53548903 MINERAL POINT ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019MERCY MALL CLINIC, 1010 N WASHINGTON, JANESVILLE, WI 535451
01/01/2018 12/31/2019MERCY CLINIC NORTH, 3400 DEERFIELD DRIVE, JANESVILLE, WI 535461
01/01/2018 12/31/2019MERCY EAST CLINIC, 3524 E MILWAUKEE STREET, JANESVILLE, WI 535461
01/01/2018 12/31/2019MERCY OPTIONS BEHAVIORAL HEALTH CLINIC - MILTON, 725 S. JANESVILLE ST, MILTON, WI 535631
01/01/2018 12/31/2019MERCY OPTIONS-OUTPATIENT SERVICES, 507 W MAIN ST, WHITEWATER, WI 531901
01/01/2018 12/31/2019MERCY WEST CLINIC, 1000 MINERAL POINT ROAD, JANESVILLE, WI 535451
01/01/2018 12/31/2019MERCY BELOIT CLINIC, 2825 PRAIRIE AVENUE, BELOIT, WI 535112
01/01/2018 12/31/2019MERCY EVANSVILLE CLINIC, 300 UNION STREET, EVANSVILLE, WI 535362
01/01/2018 12/31/2019MERCY OPTIONS BEHAVIORAL HEALTH CLINIC - MERCYCARE, 580 N. WASHINGTON ST., JANESVILLE, WI 53548
2
01/01/2018 12/31/2019MERCY OPTIONS BH CLINIC - WALWORTH, N2846 STATE ROAD 67, WILLIAMS BAY, WI 531912
2741MERCY OPTIONS CHILD AND ADOLESCENT DAY TREATMENT
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/01/2007
(608) 758-5761
(608) [email protected] USGAARD
County: RockJANESVILLE, WI 535452600 HUMES RD, SUITE 100
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 2 DHS 40.11(2)(B) 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
3030ROCK COUNTY COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/2014
(608) 757-5545
(608) [email protected] SINGER
County: RockJANESVILLE, WI 535461900 CENTER AVE
CCS Affiliaton: 08/01/2014Begin: End: Lead:JRW Tri County Regional CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
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1807ROCK COUNTY COUNSELING CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201610/01/1975
(608) 757-5545
(608) [email protected] LAKE
County: RockJANESVILLE, WI 53548113 S FRANKLIN STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018ROCK COUTNY JOB CENTER, 1900 CENTER AVENUE, JANESVILLE, WI 535461
09/01/2016 08/31/2018COURT STREET BRANCH OFFICE, 303 W. COURT ST., JANESVILLE, WI 535482
09/01/2016 08/31/2018ROCK CNTY CNSLNG CTR - BELOIT BRANCH, 64 ECLIPSE CENTER, BELOIT, WI 535112
09/01/2016 08/31/2018ROCK CNTY CNSLNG CTR - HEALTHCARE CTR BRANCH, 3530 N COUNTY TRK HWY F, JANESVILLE, WI 53547
2
1805ROCK COUNTY HUMAN SERVICES DEPT JANESVILLE COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201709/01/1989
(608) 757-5545
(608) [email protected] COTTINGTON
County: RockJANESVILLE, WI 53548113 S FRANKLIN ST
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
1265TRIVIUM DBA CROSSROADS COUNSELING CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201709/01/1977
(608) 755-5267
(608) [email protected] PERRY
County: RockJANESVILLE, WI 5354817 S RIVER STREET #254
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 1 DHS 40.11(2)(A) 10/01/2017 09/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier10/01/2017 09/30/2019CROSSROADS COUNSELING CENTER, 778 LOIS DRIVE, SUN PRAIRIE, WI 535901
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Substance Abuse Program Directory By County, City, and Provider Name
RUSKLADYSMITH
2948ACCESS, INC COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/06/2011
(715) 532-9774
(715) [email protected] WOLF
County: RuskLADYSMITH, WI 54848108 W 2ND STREET N
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 09/01/2017 08/31/2019
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SAINT CROIXHUDSON
1118BURKWOOD TREATMENT CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201803/01/1988
(715) 381-0158
(715) [email protected] BROOKS
County: Saint CroixHUDSON, WI 54016615 OLD MILL ROAD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 05/01/2018 04/30/2020
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
1173HUDSON HOSPITAL & CLINICS, PROGRAMS FOR CHANGE
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201709/01/1990
(715) 531-6766
(715) 531-6755Peter.J.Vandusartz@HudsonHospitPETER VAN DUSARTZ
County: Saint CroixHUDSON, WI 54016405 STAGELINE ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2019HUDSON HOSPITAL AND CLINIC, 411 STAGELINE ROAD, HUDSON, WI 540161
NEW RICHMOND
3110ST. CROIX COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES - CCS
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201804/01/2016
(715) 246-8284
(715) [email protected] KIRT
County: Saint CroixNEW RICHMOND, WI 540171752 DORSET LANE
CCS Affiliaton: 04/01/2016Begin: End: Lead:Eau Claire and St. Croix CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2018 03/31/2020
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
1856ST. CROIX COUNTY HEALTH & HUMAN SERVICES - BEHAVIORAL HEALTH
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201601/01/1990
(715) 246-8461
(715) [email protected] KIRT
County: Saint CroixNEW RICHMOND, WI 540171752 DORSET LANE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 06/01/2017 11/30/2018
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1855ST. CROIX COUNTY HEALTH & HUMAN SERVICES BEHAVIORAL HEALTH
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201610/01/1975
(715) 246-8284
(715) [email protected] KIRT
County: Saint CroixNEW RICHMOND, WI 540171752 DORSET LANE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 06/01/2017 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 06/01/2017 11/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 12/01/2016 11/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 06/01/2017 11/30/2018
Services
NO BRANCH LOCATIONS
3161WESTFIELDS HOSPITAL
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201712/01/2016
(715) 243-2851
(715) [email protected] BARTLETT
County: Saint CroixNEW RICHMOND, WI 54017535 HOSPITAL ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SAINT LOUISDULUTH
2064CENTER FOR ALCOHOL & DRUG TREATMENT DETOX
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201709/01/1998
(218) 529-3440
(218) [email protected] ANDERSON
County: Saint LouisDULUTH, MN 558051402 E. SUPERIOR STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED RESIDENTIAL DETOX DHS 75.07 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SAUKBARABOO
2713SAUK COUNTY DEPARTMENT OF HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/2007
(608) 355-4299
(608) [email protected] BOESL
County: SaukBARABOO, WI 53913505 BROADWAY
CCS Affiliaton: 07/01/2014Begin: End: Lead:Wisconsin River CCS Collaboration
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 03/01/2017 02/28/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2017 02/28/2019SAUK COUNTY DEPT HUMAN SERVICES REEDSBURG, 425 - 6TH STREET, REEDSBURG, WI 539591
1824SAUK COUNTY DEPARMENT OF HUMAN SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/1988
(608) 355-4299
(608) [email protected] MIJAL
County: SaukBARABOO, WI 53913505 BROADWAY STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 01/01/2018 12/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 01/01/2018 12/31/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019SAUK COUNTY DHS - REEDSBURG OFFICE, 425 SIXTH STREET, REEDSBURG, WI 539591
2087SSM HEALTH TREATMENT & RECOVERY CENTER
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201811/25/1998
(608) 356-1365
(608) [email protected] LOHMAN
County: SaukBARABOO, WI 539131510 JEFFERSON STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 02/01/2018 01/31/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2018 01/31/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
2586ST. CLARE HOSPITAL & HEALTH SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/202004/01/201807/01/2004
(608) 356-1367
(608) [email protected] SCHWARTZ
County: SaukBARABOO, WI 53913707 - 14TH STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 04/01/2018 03/31/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3127TELLURIAN OUTPATIENT SERVICES
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201706/01/2016
(608) 222-6694
(608) [email protected] CROOKS
County: SaukBARABOO, WI 53913414 BROADWAY ST SUITE 101
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 11/01/2017 05/31/2019
CSAS-INTERVENTION DHS 75.16 06/01/2017 05/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 06/01/2017 05/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 06/01/2017 05/31/2019
Services
NO BRANCH LOCATIONS
PRAIRIE DU SAC
3138PATHWAY TO WELLNESS COMMUNITY CLINIC, LLC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/01/2016
(608) [email protected] KIRCH
County: SaukPRAIRIE DU SAC, WI 53578560 4TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/20/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
Services
Setting Begin/End DatesNon-Certified School Setting(s)07/01/2017 06/30/2019SAUK PRAIRIE HIGH SCHOOL, 105 NINTH ST, PRAIRIE DU SAC, WI 53578
REEDSBURG
2774GOODMAN'S BEHAVIORAL HEALTH CLINIC LLC
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/06/2008
(608) 768-4646
(608) [email protected] GOODMAN
County: SaukREEDSBURG, WI 539592213 E MAIN STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
1823SAUK COUNTY DEPARTMENT OF HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Central Office
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/1990
(608) 524-7980
(608) [email protected] CIBULKA
County: SaukREEDSBURG, WI 53959425 SIXTH STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SAWYERHAYWARD
1486LAC COURTE ORIELLES BEHAVIORAL HEALTH
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201803/01/1987
(715) 634-6107
(715) [email protected] BERGUM
County: SawyerHAYWARD, WI 5484313447 W COUNTY HIGHWAY B SUITE 1
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 07/01/2018 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2018 06/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2019LAC COURTE OREILLES OJIBWE SCHOOL, 8575 N. TREPANIA ROAD, HAYWARD, WI 548433
3160LCO CCS
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201805/01/2017
(715) 634-6107
(715) [email protected] BERGUM
County: SawyerHAYWARD, WI 5484313447 W COUNTY B, SUITE 2
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL POPULATION-BASED DHS 36 05/01/2018 04/30/2019
Services
NO BRANCH LOCATIONS
2330NORTHLAND COMMUNITY SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201602/01/2001
(715) 634-2533
(715) [email protected] LUND
County: SawyerHAYWARD, WI 5484310270 OLKER ROAD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
3166NORTHWOODS BEHAVIORAL HEALTH SERVICES LLC
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201803/01/201703/01/2017
(715) 634-4765
(715) 634-4673dcousins@northwoodsbehavioralheDANIEL COUSINS SR.
County: SawyerHAYWARD, WI 5484315617-B US HWY 63N
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1825SAWYER COUNTY HEALTH & HUMAN SERVICES/INFORMATION & REFERRAL CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201804/01/1979
(715) 634-3580
(715) [email protected] CARLSON
County: SawyerHAYWARD, WI 5484310610 MAIN ST SUITE 224
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
CSAS-PREVENTION DHS 75.04 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020TRANSITION HOUSE, 16208 WOOD RIDGE LANE, HAYWARD, WI 548431
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Substance Abuse Program Directory By County, City, and Provider Name
SHAWANOBOWLER
1882STOCKBRIDGE-MUNSEE HEALTH AND WELLNESS CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201606/19/2014
(715) 793-1312
(715) [email protected] MOHAWK
County: ShawanoBOWLER, WI 54416W12802 COUNTY HWY A
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 07/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
GRESHAM
1554MAEHNOWESEKIYAH WELLNESS CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201711/21/1989
(715) 799-3836
(715) [email protected] ANN DICK
County: ShawanoGRESHAM, WI 54128N2150 KESAEHKAHTEK
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 12/01/2017 11/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
CSAS-PREVENTION DHS 75.04 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
SHAWANO
1831SHAWANO COUNTY DEPARTMENT OF HUMAN SERVICES - LAKELAND CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201703/01/1977
(715) 526-5542
(715) [email protected] FROST
County: ShawanoSHAWANO, WI 54166504 LAKELAND ROAD
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 01/01/2017 12/31/2018
CSAS-EMERGENCY OUTPATIENT WITH TELEHEALTH DHS 75.05 01/01/2017 12/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2017 12/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 01/01/2017 12/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 01/01/2017 12/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2242SHAWANO COUNTY DEPARTMENT OF HUMAN SERVICES - LAKELAND CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/01/2000
(715) 526-5542
(715) [email protected] THOUSAND
County: ShawanoSHAWANO, WI 54166504 LAKELAND ROAD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COM SUPPORT PROGRAM W/TELEHEALTH DHS 63 01/01/2017 12/31/2018
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
2863SHAWANO COUNTY DEPARTMENT OF HUMAN SERVICES - LAKELAND CENTER CCS
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201705/06/2014
(715) 526-5542
(715) [email protected] THOUSAND
County: ShawanoSHAWANO, WI 54166504 LAKELAND ROAD
CCS Affiliaton: 12/01/2014Begin: End: Lead:Lakeshore Recovery Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 07/01/2017 06/30/2019
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
1832THEDACARE MEDICAL CENTER - SHAWANO
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201810/01/1978
(715) 526-7205
(715) [email protected] BLOCK
County: ShawanoSHAWANO, WI 54166100 COUNTY ROAD B
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SHEBOYGANPLYMOUTH
2677LIFE POINT COUNSELING, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201607/06/2006
(920) 449-4247
(920) [email protected] NIVER
County: SheboyganPLYMOUTH, WI 53073433A EAST MILL STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 07/31/2018
Services
NO BRANCH LOCATIONS
SHEBOYGAN
1925AURORA SHEBOYGAN CLINIC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201808/01/201607/01/1986
(920) 459-1483
(920) [email protected] LEE-JOHNSON
County: SheboyganSHEBOYGAN, WI 530812414 KOHLER MEMORIAL DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2016 06/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 08/01/2016 06/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier04/12/2018 06/30/2018AURORA BEHAVIORAL HEALTH WELLNESS CENTER, 1221 N 26TH ST, SHEBOYGAN, WI 530811
08/01/2016 06/30/2018AURORA SHEBOYGAN CLINIC, 2600 KILEY WAY, PLYMOUTH, WI 530731
1835AURORA SHEBOYGAN MEMORIAL MEDICAL CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201805/01/1987
(920) 451-5123
(920) [email protected] KNITT
County: SheboyganSHEBOYGAN, WI 530832629 N 7TH STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 05/01/2018 04/30/2020
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 05/01/2018 04/30/2020
MENTAL HEALTH-INPATIENT DHS 61.71 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
3171AURORA SHEBOYGAN MEMORIAL MEDICAL CENTER-AURORA BEHAVIORAL HEALTH CENTER
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201812/26/2016
(920) 451-5123
(920) [email protected] KNITT
County: SheboyganSHEBOYGAN, WI 530811221 N 26TH STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 05/01/2018 04/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH-DAY TREATMENT DHS 61.75 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2869LEPAK JOSTSONS INC DBA DYNAMIC FAMILY SOLUTIONS
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201608/19/2009
(920) 358-5970
(920) [email protected] A LEPAK JOSTSONS
County: SheboyganSHEBOYGAN, WI 53081615 SOUTH 8TH ST SUITE 220
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/14/2018 08/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 05/29/2018 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 05/29/2018 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018DYNAMIC FAMILY SOLUTIONS - STURGEON BAY, 101 NORTH 4TH AVENUE, STURGEON BAY, WI
542352
09/01/2016 08/31/2018DYNAMIC FAMILY SOLUTIONS, 3021 HOLMGREN WAY, GREEN BAY, WI 543052
09/01/2016 08/31/2018DYNAMIC FAMILY SOLUTIONS, ONE WALDO BLVD SUITE 3, MANITOWOC, WI 542202
1656NETT-WORK FAMILY COUNSELING, LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201802/27/1998
(920) 458-6439
(920) [email protected] L. NETT
County: SheboyganSHEBOYGAN, WI 530832801 CALUMET DRIVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2018 02/29/2020NETT-WORK FAMILY COUNSELING LLC, 1011 - 10TH STREET #1, MANITOWOC, WI 542201
03/01/2018 02/29/2020NETT-WORK FAMILY COUNSELING LLC, 1403 MILWAUKEE DR, NEW HOLSTEIN, WI 530611
03/01/2018 02/29/2020NETT-WORK FAMILY COUNSELING LLC, 621 E MILL ST, PLYMOUTH, WI 530731
03/01/2018 02/29/2020NETT-WORK FAMILY COUNSELING, LLC, 3321 SOUTH 12TH ST, SHEBOYGAN, WI 530812
1699NORTHSHORE CLINIC LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201808/01/1991
(920) 457-8867
(920) [email protected] DIELENTHEIS
County: SheboyganSHEBOYGAN, WI 53081805 NORTH 6TH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
Setting Begin/End DatesNon-Certified School Setting(s)03/01/2018 02/29/2020JEFFERSON ELEMENTARY SCHOOL, 1538 N 15TH ST, SHEBOYGAN, WI 53081
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Substance Abuse Program Directory By County, City, and Provider Name
2931QUALITY ADDICTION MANAGEMENT, INC DBA SHEBOYGAN COMPREHENSIVE TREATMENT CTR
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201601/03/2011
(920) 458-6623
(920) [email protected] OKOROMA
County: SheboyganSHEBOYGAN, WI 530812842 S BUSINESS DRIVE
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/10/2017 08/31/2018QAM, INC DBA SHEBOYGAN CTC, 2902 S BUSINESS DRIVE, SHEBOYGAN, WI 530812
3194SHEBOYGAN CO HEALTH AND HUMAN SERVICES CSP
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201901/29/201801/29/2018
(920) 459-6459
(920) [email protected] KREPSKY
County: SheboyganSHEBOYGAN, WI 530811011 N 8TH ST
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 01/29/2018 01/31/2019
Services
NO BRANCH LOCATIONS
1834SHEBOYGAN COUNTY DEPT OF HEALTH AND HUMAN SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201810/01/201607/01/1986
(920) 459-4353
(920) [email protected] A GALLAWAY
County: SheboyganSHEBOYGAN, WI 530811011 N 8TH STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 10/01/2016 09/30/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 10/01/2016 09/30/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 10/01/2016 09/30/2018
Services
NO BRANCH LOCATIONS
2667SHEBOYGAN COUNTY HEALTH & HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/202006/01/201805/01/2006
(920) 459-4353
(920) [email protected] KREPSKY
County: SheboyganSHEBOYGAN, WI 530811011 N 8TH STREET
CCS Affiliaton: 01/01/2015Begin: End: Lead:Lakeshore Recovery Collaborative
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 06/01/2018 05/31/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3070ST. NICHOLAS HOSPITAL DBA PREVEA HEALTH
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201710/27/2014
(920) 272-1201
(920) [email protected] STUMBRAS
County: SheboyganSHEBOYGAN, WI 530813425 SUPERIOR AVE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2019PREVEA HEALTH KOHLER, 950 WOODLAKE RD, KOHLER, WI 530441
12/01/2017 11/30/2019PREVEA PLYMOUTH HEALTH CENTER, 825 WALTON DRIVE, PLYMOUTH, WI 530731
WALDO
3156PATHWAYS DETOX LLC
Surveyor: Erin Taylor
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/27/2017
(920) 894-1373
(920) [email protected] COOPER
County: SheboyganWALDO, WI 530931102 W 1ST STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED RESIDENTIAL DETOX DHS 75.07 03/01/2018 02/29/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
TAYLORMEDFORD
2753COUNSELING CONNECTION OF MEDFORD
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/2007
(715) 748-4407
(715) [email protected] SCHULTZ
County: TaylorMEDFORD, WI 54451123 WEST STATE STREET #4
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018PHOENIX HOUSE, 600 W. HICKORY STREET, GILMAN, WI 544331
09/25/2017 08/31/2018MEDFORD ADULT DIPLOMA ACADEMY & ALT ED PROGRAM, 624 E COLLEGE ST, MEDFORD, WI 54451
3
09/01/2016 08/31/2018MEDFORD ELEMENTARY SCHOOL-COUNSELING CONNECTION, 1065 W BROADWAY AVE, MEDFORD, WI 54451
3
09/01/2016 08/31/2018MEDFORD HIGH SCHOOL-COUNSELING CONNECTION, 1015 W BROADWAY AVE, MEDFORD, WI 54451
3
09/01/2016 08/31/2018MEDFORD MIDDLE SCHOOL-COUNSELING CONNECTION, 509 CLARK ST, MEDFORD, WI 544513
09/25/2017 08/31/2018STETSONVILLE ELEMENTARY SCHOOL, W5338 COUNTY RD A, STETSONVILLE, WI 544803
3169NORTH CENTRAL REGION CCS PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201802/01/201702/01/2017
(715) 748-3342
(715) [email protected] KETELHUT
County: TaylorMEDFORD, WI 54451540 E COLLEGE STREET
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 02/01/2017 01/31/2018
CCS REGIONAL MODEL MULTI-COUNTY W/TELEHEALTH DHS 36 02/01/2017 01/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier02/01/2017 01/31/2018IRON CO HUMAN SERVICES & ASSOCIATES, 300 TACONITE ST #201, HURLEY, WI 545341
3193NORTH CENTRAL REGION CCS PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201801/01/2018
(715) 748-3342
(715) [email protected] KETELHUT
County: TaylorMEDFORD, WI 54451540 E COLLEGE STREET
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 01/01/2018 12/31/2018
CCS REGIONAL MODEL MULTI-COUNTY W/TELEHEALTH DHS 36 01/01/2018 12/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2018IRON COUNTY HUMAN SERVICES & ASSOC, 300 TACONITE STREET, STE 201, HURLEY, WI 545341
01/01/2018 12/31/2018PRICE COUNTY HEALTH AND HUMAN SVS, 104 SOUTH EYDER, PHILLIPS, WI 545551
01/01/2018 12/31/2018SAWYER COUNTY HEALTH AND HUMAN SVS, 10610 MAIN STREET, STE 224, HAYWARD, WI 548431
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Substance Abuse Program Directory By County, City, and Provider Name
1898TAYLOR COUNTY HUMAN SERVICES DEPARTMENT
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201806/01/1982
(715) 748-3342
(715) [email protected] MEYER
County: TaylorMEDFORD, WI 54451540 E. COLLEGE STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 07/01/2018 06/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
TREMPEALEAUINDEPENDENCE
2543WEST CENTRAL WISCONSIN BEHAVIORAL HEALTH CLINIC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/03/2004
(715) 985-3029
(715) [email protected] PYKA
County: TrempealeauINDEPENDENCE, WI 5474723062 WHITEHALL RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
WHITEHALL
3170TREMPEALEAU COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201803/01/2017
(715) 538-4274
(715) [email protected] SUCHLA
County: TrempealeauWHITEHALL, WI 5477336245 MAIN STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 03/01/2018 02/28/2019
Services
NO BRANCH LOCATIONS
3094TREMPEALEAU COUNTY HUMAN SERVICES - CCS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/01/2015
(715) 538-4174
(715) [email protected] SUCHLA
County: TrempealeauWHITEHALL, WI 5477336245 MAIN ST
CCS Affiliaton: 09/01/2015Begin: End: Lead:CCS of Clark and Trempealeau Counties
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 09/01/2016 08/31/2018
CCS REGIONAL MODEL SHARED SERVICES W/TELEHEALTH DHS 36 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
VERNONVIROQUA
1317FAMILY AND CHILDREN'S CENTER, INC. COMMUNITY SUPPORT PROGRAM
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201701/01/1996
(608) 637-8500
(608) [email protected] HOWE
County: VernonVIROQUA, WI 546651321 N MAIN ST
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
3092STRIVE COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201808/01/201608/01/2015
(608) 637-5505
(608) [email protected] EITLAND
County: VernonVIROQUA, WI 54665318 FAIRLANE DRIVE SUITE 100
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL MULTI-COUNTY DHS 36 08/01/2016 07/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier08/01/2016 07/31/2018CRAWFORD CO DEPT. OF HUMAN SERVICES, 225 N. BEAUMONT RD SUITE 326, PRAIRIE DU CHIEN,
WI 538212
1963VERNON MEMORIAL HOSPITAL
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201602/01/1978
(608) 637-2141
(608) [email protected] FINLEY
County: VernonVIROQUA, WI 54665507 S. MAIN STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
VILASLAC DU FLAMBEAU
1325FAMILY RESOURCE CENTER
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201709/01/1988
(715) 588-3903
(715) [email protected] SAMUELSON
County: VilasLAC DU FLAMBEAU, WI 54538533 PEACE PIPE ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2018DOMESTIC ABUSE PROGRAM, 157 CEDAR AVENUE, LAC DU FLAMBEAU, WI 545381
09/01/2017 08/31/2018SOBER HOME - MEN'S, 1219 ARNOLD STOCK ROAD, LAC DU FLAMBEAU, WI 545381
09/01/2017 08/31/2018SOBER HOME - WOMEN'S, 2355 BOBIDOSH POINT LANE, LAC DU FLAMBEAU, WI 545381
09/01/2017 08/31/2018LAC DU FLAMBEAU PUBLIC SCHOOL, 2899 HWY 47, LAC DU FLAMBEAU, WI 545383
09/01/2017 08/31/2018LAKELAND UNION HIGH SCHOOL, 9573 STATE HWY 70, MINOCQUA, WI 545483
3100GOOKOMIS ENDAAD
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201803/01/201801/19/2016
(715) 588-1889
(715) [email protected] THOMPSON
County: VilasLAC DU FLAMBEAU, WI 545383378 N SCHILLEMAN RD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 04/30/2018
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 03/01/2018 04/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 04/30/2018
Services
NO BRANCH LOCATIONS
3071LAC DU FLAMBEAU HEALTH & HUMAN SERVICES CCS
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201805/01/201702/01/2015
(715) 588-3855
(715) [email protected] THUNDER
County: VilasLAC DU FLAMBEAU, WI 54538418 LITTLE PINES ROAD
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL POPULATION-BASED DHS 36 05/01/2017 01/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WALWORTHELKHORN
1262CREDENCE THERAPY ASSOCIATES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/19/1995
(262) 723-8308
(262) [email protected] STEEN
County: WalworthELKHORN, WI 531211-1/2 W. GENEVA STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2016 11/30/2018BADGER HIGH SCHOOL, 220 E. SOUTH STREET, LAKE GENEVA, WI 531473
12/01/2016 11/30/2018BIG FOOT HIGH SCHOOL, 401 DEVILS LANE PO BOX 89, WALWORTH, WI 531843
12/01/2016 11/30/2018DELAVAN-DARIEN HIGH SCHOOL, 150 CUMMINGS ST, DELAVAN, WI 531153
12/01/2016 11/30/2018ELKHORN AREA HIGH SCHOOL, 482 EAST GENEVA STREET, ELKHORN, WI 531213
12/01/2016 11/30/2018ELKHORN AREA MIDDLE SCHOOL, 627 EAST COURT ST., ELKHORN, WI 531213
12/01/2016 11/30/2018JACKSON ELEMENTARY SCHOOL, 13 NORTH JACKSON STREET, ELKHORN, WI 531213
12/01/2016 11/30/2018LAKE GENEVA MIDDLE SCHOOL, 600 BLOOMFIELD ROAD, LAKE GENEVA, WI 531473
12/01/2016 11/30/2018PHOENIX MIDDLE SCHOOL, 414 BELOIT ST, DELAVAN, WI 531153
12/01/2016 11/30/2018TIBBETS ELEMENTARY SCHOOL, W5218 COUNTY ROAD A, ELKHORN, WI 531213
12/01/2016 11/30/2018WEST SIDE ELEMENTARY SCHOOL, 222 SUNSET DRIVE, ELKHORN, WI 531213
2694WALWORTH COUNTY DEPT OF HEALTH & HUMAN SERVICES COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201711/08/2006
(262) 741-3217
(262) [email protected] KADLEC
County: WalworthELKHORN, WI 53121W4051 COUNTY ROAD NN
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
2889WALWORTH COUNTY DHHS COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201701/20/2010
(262) 741-3217
(262) [email protected] KADLEC
County: WalworthELKHORN, WI 53121W4051 COUNTY ROAD NN
CCS Affiliaton: 08/01/2014Begin: End: Lead:JRW Tri County Regional CCS
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
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1967WALWORTH COUNTY HEALTH AND HUMAN SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201610/01/1975
(262) 741-3217
(262) [email protected] NEVICOSI
County: WalworthELKHORN, WI 53121W4051 COUNTY TRUNK NN
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 06/08/2017 08/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WASHBURNSHELL LAKE
2926WASHBURN COUNTY COMMUNITY SUPPORT PROGRAM
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201711/01/2010
(715) 468-1588
(715) [email protected] SCHRANKEL
County: WashburnSHELL LAKE, WI 54871600 E COUNTY ROAD B
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
SPOONER
2631ACCESS, INC.
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/2006
(715) 635-4861
(715) [email protected] WOLF
County: WashburnSPOONER, WI 548014851 HWY 63 SOUTH
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019ACCESS, INC DBA AURORA COMMUNITY COUNSELING, 1302 ARLEN CT, EAU CLAIRE, WI 547031
01/01/2018 12/31/2019ACCESS, INC, 330 E LASALLE STREET, BARRON, WI 548121
01/01/2018 12/31/2019ACCESS, INC. DBA AURORA COMMUNITY COUNSELING, 345 FRENETTE DRIVE, SUITE 3, CHIPPEWA FALLS, WI 54729
1
01/01/2018 12/31/2019ACCESS, INC - LADYSMITH, 108 W. 2ND STREET N, LADYSMITH, WI 548482
01/01/2018 12/31/2019ACCESS, INC DBA AURORA COMMUNITY COUNSELING, 406 TECHNOLOGY DR. E SUITE C, MENOMONIE, WI 54751
2
01/01/2018 12/31/2019ACCESS, INC. - SIREN, 24248 STATE HWY 35/70, UNIT D, SIREN, WI 548722
01/01/2018 12/31/2019ACCESS INC-LADYSMITH ELEMENTARY SCHOOL, 624 EAST 6TH STREET, LADYSMITH, WI 548483
01/01/2018 12/31/2019ACCESS, INC - SPOONER MIDDLE SCHOOL, 750 OAK STREET, SPOONER, WI 548013
01/01/2018 12/31/2019ACCESS, INC - CADOTT HIGH SCHOOL, 426 MYRTLE STREET, CADOTT, WI 547273
01/01/2018 12/31/2019ACCESS, INC. - SPOONER ELEMENTARY SCHOOL, 1821 SCRIBNER STREET, SPOONER, WI 548013
01/01/2018 12/31/2019ACCESS, INC. - SPOONER HIGH SCHOOL, 801 COUNTY HWY A, SPOONER, WI 548013
01/01/2018 12/31/2019ACCESS, INC-LADYSMITH MIDDLE SCHOOL, 115 E 6TH STREET SOUTH, LADYSMITH, WI 548483
01/01/2018 12/31/2019ACCESS, INC-SCHOOL DISTRICT OF FLAMBEAU, N 4540 CTY HWY I, TONY, WI 545633
01/01/2018 12/31/2019GRANTSBURG MIDDLE/SENIOR HIGH SCHOOL, 480 EAST JAMES AVENUE, GRANTSBURG, WI 548403
3198WHOLE LIFE SERVICES
Surveyor: Polly Wong
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/23/201804/23/2018
(715) 645-0336
(715) [email protected] EHRICH
County: WashburnSPOONER, WI 54801819 ASH STREET STE SO2O
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/23/2018 03/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WASHINGTONJACKSON
1243ELEVATE, INC.
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/1990
(262) 677-2124
(262) [email protected] SIMON
County: WashingtonJACKSON, WI 53037N169 W21005 MEADOW LANE
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 03/01/2017 02/28/2019
CSAS-PREVENTION DHS 75.04 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
KEWASKUM
2598EXODUS TRANSITIONAL CARE FACILITY, INC.
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201801/01/2005
(262) 626-8431
(262) [email protected] COLWIN
County: WashingtonKEWASKUM, WI 530401421 FOND DU LAC AVENUE
Service Begin/End DatesAdm Code
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
SLINGER
3102MILLENIUM MANNOR, LLC D/B/A THE MANOR (4509)
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201611/24/2015
(847) 510-0662
(414) [email protected] HOLLANDER
County: WashingtonSLINGER, WI 530864509 ARTHUR ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
3103MILLENIUM MANOR, LLC D/B/A THE MANOR (4505)
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201708/10/2016
(847) 510-0662
(847) [email protected] HOLLANDER
County: WashingtonSLINGER, WI 530864505 ARTHUR ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WEST BEND
1017AFFILIATED CLINICAL SERVICES INC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201810/01/1984
(262) 338-9767
(262) [email protected] FEUCHT
County: WashingtonWEST BEND, WI 53095111 E WASHINGTON STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020AFFILIATED CLINICAL SERVICES INC, 38 SELL DRIVE #B, HARTFORD, WI 530272
Setting Begin/End DatesNon-Certified School Setting(s)07/01/2018 06/30/2020BADGER MIDDLE SCHOOL, 727 S 6TH AVE, ROOM #112, WEST BEND, WI 53095
07/01/2018 06/30/2020WEST BEND EAST & WEST HIGH SCHOOL, 1305 E DECORAH RD, RM N 15, WEST BEND, WI 53095
2851AFFILIATED CLINICAL SERVICES INC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201803/01/2009
(262) 338-9767
(262) [email protected] FEUCHT
County: WashingtonWEST BEND, WI 53095111 EAST WASHINGTON STREET
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/01/2018 02/28/2019
Services
NO BRANCH LOCATIONS
2641CALM HARBOR
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201702/01/2006
(262) 677-2124
(262) [email protected] HARPER
County: WashingtonWEST BEND, WI 53095141 SOUTH 8TH AVE
Service Begin/End DatesAdm Code
CSAS-RESIDENTIAL INTOXICATION MONITORING DHS 75.09 03/01/2017 02/28/2019
Services
NO BRANCH LOCATIONS
2303WASHINGTON COUNTY MENTAL HEALTH CENTER COMMUNITY SUPPORT PROGRAM
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201810/01/1975
(262) 335-6827
(262) [email protected] HAUPT
County: WashingtonWEST BEND, WI 53095333 E. WASHINGTON ST SUITE 2100
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 05/01/2018 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2580WASHINGTON COUNTY MENTAL HEALTH CENTER COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/01/2005
(262) 335-6827
(262) [email protected] MOGLOWSKY
County: WashingtonWEST BEND, WI 53095333 E WASHINGTON STREET, #2100
CCS Affiliaton: 01/01/2015Begin: End: Lead:Lakeshore Recovery Collaborative
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 03/01/2018 02/29/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WAUKESHABROOKFIELD
1237CORNERSTONE COUNSELING SERVICES, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/29/202003/01/201803/01/1993
(262) 821-6180
(262) [email protected] TEUTEBERG
County: WaukeshaBROOKFIELD, WI 5300516535 W. BLUEMOUND ROAD, #200
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2018 02/29/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2018 02/29/2020
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC, 5007 S HOWELL AVENUE, SUITE 350, MILWAUKEE,
WI 532072
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 10850 W PARK PLACE, #100, MILWAUKEE, WI 532242
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 11649 N PORT WASHINGTON RD, #201, MEQUON, WI 53092
2
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 1230 CORPORATE CENTER DR, STE 100, OCONOMOWOC, WI 53066
2
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 400 BAY VIEW ROAD, SUITE C, MUKWONAGO, WI 53149
2
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 4811 S 76TH ST #208, GREENFIELD, WI 532202
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 5555 N PORT WASHINGTON ROAD, #200, GLENDALE, WI 53217
2
03/01/2018 02/29/2020CORNERSTONE COUNSELING SERVICES, INC., 741 N GRAND AVENUE, #302, WAUKESHA, WI 531862
3122HEALING CORNER, LLC
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201705/02/2016
(262) 373-0148
(262) [email protected] POVLETICH
County: WaukeshaBROOKFIELD, WI 5304519115 W CAPITOL DRIVE, SUITE 117
Service Begin/End DatesAdm Code
CSAS-AMBULATORY DETOXIFICATION DHS 75.08 07/27/2017 04/30/2019
CSAS-DAY TREATMENT DHS 75.12 05/01/2017 04/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
2654WHEATON FRANCISCAN BEHAVIORAL HEALTH ST. JOSEPH HOSPITAL II
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201707/22/2005
(414) 874-6291
(414) [email protected] HESS
County: WaukeshaBROOKFIELD, WI 5300513950 W CAPITOL DR 2ND FLOOR
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2019ELMBROOK MEMORIAL HOSPITAL, 19333 W MORTH AVE #304, BROOKFIELD, WI 530451
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Substance Abuse Program Directory By County, City, and Provider Name
ELM GROVE
3189RED OAK COUNSELING LTD
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/05/201803/05/2018
(262) 780-1022
(262) [email protected] GUENTHER
County: WaukeshaELM GROVE, WI 5312212970 WEST BLUEMOUND RD #200
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/05/2018 02/28/2019
Services
NO BRANCH LOCATIONS
HARTLAND
2134ALLIANCE COUNSELING CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201708/06/1999
(262) 781-3672
(262) [email protected] BINDER
County: WaukeshaHARTLAND, WI 53029155 E CAPITOL DRIVE, SUITE 6A
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2017 01/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier02/01/2017 01/31/2019ALLIANCE COUNSELING CENTER, 2312 N GRANDVIEW BOULEVARD, #103, WAUKESHA, WI 531881
02/01/2017 01/31/2019ALLIANCE COUNSELING CENTER, N91 W17194 APPLETON AVE, #105, MENOMONEE FALLS, WI 53051
1
3136YOUR CHOICE TO LIVE INC
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201710/05/2016
(262) 367-0110
(262) [email protected] NOWAKOWSKI
County: WaukeshaHARTLAND, WI 53029138 NORTH AVENUE
Service Begin/End DatesAdm Code
CSAS-PREVENTION DHS 75.04 12/01/2017 11/30/2019
Services
NO BRANCH LOCATIONS
MENOMONEE FALLS
2076FROEDTERT & THE MEDICAL COLLEGE OF WI-COMMUNITY MEMORIAL HOSPITAL
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201610/01/1982
(262) 257-2570
(262) [email protected] BENSON
County: WaukeshaMENOMONEE FALLS, WI 53051W180 N8085 TOWN HALL ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 09/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
MENTAL HEALTH-INPATIENT DHS 61.71 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
06/26/2018 Page 156 of 172
Substance Abuse Program Directory By County, City, and Provider Name
MUSKEGO
3162AURORA PSYCHIATRIC HOSPITAL MUSKEGO PROGRAMS
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201812/14/2016
(414) 422-2190
(414) [email protected] SURFUS-LEWISTON
County: WaukeshaMUSKEGO, WI 53150S74W16775 JANESVILLE ROAD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/01/2018 12/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
MENTAL HEALTH-DAY TREATMENT DHS 61.75 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
OCONOMOWOC
1810ROGERS MEMORIAL HOSPITAL
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201708/01/1988
(262) 646-3158
(262) [email protected] SCHULTZ
County: WaukeshaOCONOMOWOC, WI 5306634700 VALLEY ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 11/01/2017 10/31/2019
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 11/01/2017 10/31/2019
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 11/01/2017 10/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
2070ROGERS MEMORIAL HOSPITAL - HERRINGTON RECOVERY CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 05/31/201906/01/201706/01/1998
(262) 646-3158
(262) [email protected] SCHULTZ
County: WaukeshaOCONOMOWOC, WI 5306634700 VALLEY ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 06/01/2017 05/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3099ROGERS MEMORIAL HOSPITAL - SILVER LAKE OUTPATIENT CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201609/28/2015
(262) 646-1049
(262) [email protected] SCHULTZ
County: WaukeshaOCONOMOWOC, WI 530661205 CORPORATE CENTER DRIVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 11/01/2016 10/31/2018
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 11/01/2016 10/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH-DAY TREAT/CHILDREN 2 W/TELEHEALTH DHS 40.11(2)(B) 11/01/2016 10/31/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 11/01/2016 10/31/2018
MENTAL HEALTH-DAY TREATMENT FOR CHILDREN 2 DHS 40.11(2)(B) 11/01/2016 10/31/2018
MENTAL HEALTH-DAY TREATMENT WITH TELEHEALTH DHS 61.75 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
PEWAUKEE
2798LAKE COUNTRY WELLNESS AND COUNSELING
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201608/13/2008
(262) 691-4966
(262) [email protected] GARRISON, PHD
County: WaukeshaPEWAUKEE, WI 53072285 FOREST GROVE DRIVE, #210
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
2987ROSECRANCE INC
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/202002/01/201801/16/2013
(815) 316-4638
(815) [email protected] DEROSSO
County: WaukeshaPEWAUKEE, WI 53072N27 W23957 PAUL ROAD STE 101
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 02/01/2018 01/31/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
SUSSEX
1768QUAD/MED, LLC, SUBSTANCE ABUSE COUNSELING SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201912/01/201712/01/1995
(414) 566-8038
(414) [email protected] KELSEY
County: WaukeshaSUSSEX, WI 53089W227 N6103 SUSSEX ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2017 11/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier12/01/2017 11/30/2019QUAD/GRAPHICS, 1900 W SUMNER STREET, HARTFORD, WI 530271
12/01/2017 11/30/2019QUAD/GRAPHICS, 555 S 108TH STREET, WEST ALLIS, WI 532141
12/01/2017 11/30/2019QUAD/GRAPHICS, N11896 HWY 175, PO BOX 2718, LOMIRA, WI 530481
12/01/2017 11/30/2019QUAD/GRAPHICS, N63 W23075 HWY 74, SUSSEX, WI 530891
WAUKESHA
2258ADDICTION RESOURCE COUNCIL, INC.
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201707/26/2000
(262) 524-7932
(262) [email protected] A. MUCHKA
County: WaukeshaWAUKESHA, WI 53186741 N GRAND AVE, SUITE 200
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 07/01/2017 06/30/2019
CSAS-PREVENTION DHS 75.04 07/01/2017 06/30/2019
Services
NO BRANCH LOCATIONS
2386AURORA BEHAVIORAL HEALTH CENTER - WAUKESHA
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201804/01/2002
(414) 454-6450
(414) [email protected] MONSON-DUPUIS
County: WaukeshaWAUKESHA, WI 53186W231 N1440 CORPORATE CT #310
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2018 04/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2018 04/30/2020AURORA BEHAVIORAL HEALTH CENTER-MENOMONEE FALLS, W84W16889 MENOMONEE AVE,
MENOMONEE FALLS, WI 530511
05/01/2018 04/30/2020AURORA BEHAVIORAL HEALTH CENTER-BROOKFIELD, 16985 WEST BLUEMOUND ROAD, BROOKFIELD, WI 53005
2
05/01/2018 04/30/2020AURORA BEHAVIORAL HEALTH CENTER-NEW BERLIN, 14555 W NATIONAL AVE, NEW BERLIN, WI 53151
2
05/01/2018 04/30/2020AURORA BEHAVIORAL HEALTH CENTER-SUMMIT, 36500 AURORA DRIVE, SUMMIT, WI 530662
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Substance Abuse Program Directory By County, City, and Provider Name
1382GENESIS HOUSE - LUTHERAN SOCIAL SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/1994
(262) 544-1321
(262) [email protected] AKER
County: WaukeshaWAUKESHA, WI 531881002 MOTOR AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 07/01/2018 06/30/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
3107HOPE FOR A BETTER TOMORROW
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 11/30/201812/01/201612/01/2015
(262) 910-1653
(262) [email protected]. SHEILA GISSIBL
County: WaukeshaWAUKESHA, WI 531882607 N GRANDVIEW BLVD, #110
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 12/01/2016 11/30/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 12/01/2016 11/30/2018
Services
NO BRANCH LOCATIONS
3186IRIS HEALTH CLINIC LLC
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/09/201803/09/2018
(262) 753-6897
(262) [email protected] BRUNZELLE
County: WaukeshaWAUKESHA, WI 53186403 N GRAND AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 03/09/2018 02/28/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/09/2018 02/28/2019
Services
NO BRANCH LOCATIONS
3124LSS OF WI & UPPER MI CEPHAS HOUSE
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201705/11/2016
(262) 549-6771
(262) [email protected] ADAMUS
County: WaukeshaWAUKESHA, WI 53189325 SENTINEL DRIVE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 05/01/2017 04/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1974PROHEALTH CARE MEDICAL ASSOCIATES, INC. BEHAVIORAL HEALTH SERVICES
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201806/01/1986
(262) 928-5096
(262) [email protected]. KIRK YAUCHLER
County: WaukeshaWAUKESHA, WI 53188721 AMERICAN AVENUE #501
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2018 12/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 01/01/2018 12/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - DELAFIELD, 2750 GOLF ROAD, DELAFIELD, WI 530181
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - WATERTOWN, 109 AIR PARK DR, WATERTOWN, WI 530941
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - BIG BEND RD, 2130 BIG BEND ROAD, WAUKESHA, WI 53189
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - BROOKFIELD, 2085 NORTH CALHOUN RD, BROOKFIELD, WI 53005
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - HARTLAND, 1500 WALNUT RIDGE DR, HARTLAND, WI 53029
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - MORELAND BLVD., 717 WEST MORELAND BLVD, WAUKESHA, WI 53188
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - MUKWONAGO, 240 WEST MAPLE AVE, MUKWONAGO, WI 53149
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - MUSKEGO, S69 W15636 JANESVILLE RD, MUSKEGO, WI 53150
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - NEW BERLIN, 13900 WEST NATIONAL AVE, NEW BERLIN, WI 53151
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - OCONOMOWOC, 1185 CORPORATE CENTER DR SUITE 175 - 320, OCONOMOWOC, WI 53066
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - PEWAUKEE, N16W24131 RIVERWOOD DR., WAUKESHA, WI 53188
2
01/01/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS - SUSSEX, N57 W24950 N CORPORATE CIRCLE, SUSSEX, WI 53089
2
05/04/2018 12/31/2019PHCMA, INC. BEHAVIORAL HEALTH SVS- BARSTOW ST, 210 NW BARSTOW ST, WAUKESHA, WI 53188
2
05/04/2018 12/31/2019PHCMA, INC.BEHAVIORAL HLTH SVS - BROOKFIELD, 195 DISCOVERY DR, BROOKFIELD, WI 530452
1748QUALITY ADDICTION MANAGEMENT, INC DBA WAUKESHA COMPREHENSIVE TREATMENT CTR
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201803/01/201604/01/1994
(262) 549-6698
(262) [email protected] SCHMITZ
County: WaukeshaWAUKESHA, WI 531882422 N. GRANDVIEW BOULEVARD
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 03/01/2016 08/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2016 08/31/2018
Services
NO BRANCH LOCATIONS
3129SALS RECOVERY CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 07/31/201908/01/201707/18/2016
(262) 753-6897
(262) [email protected] BRUNZELLE
County: WaukeshaWAUKESHA, WI 53186223 W WISCONSIN AVE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 08/01/2017 07/31/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 08/01/2017 07/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
3024SIXTEENTH STREET COMMUNITY HEALTH CENTERS DBA WAUKESHA COMMUNITY HEALTH CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201704/01/2014
(414) 408-5087
(262) [email protected] ELENA PEREZ, PHD
County: WaukeshaWAUKESHA, WI 53186309 EAST NORTH STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
3042WAUKESHA COUNTY DHHS CCS
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/01/2014
(262) 896-8180
(262) [email protected] BIRDEAU
County: WaukeshaWAUKESHA, WI 531881501 AIRPORT ROAD
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL POPULATION-BASED DHS 36 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020WAUKESHA CO DHHS HUMAN SERVICES CENTER, 514 RIVERVIEW AVE, WAUKESHA, WI 531881
1972WAUKESHA COUNTY HEALTH AND HUMAN SERVICES-COMMUNITY SUPPORT PROGRAM
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201710/01/1990
(262) 896-8046
(262) [email protected] HAAS
County: WaukeshaWAUKESHA, WI 531881501 AIRPORT ROAD
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
1971WAUKESHA COUNTY MENTAL HEALTH CENTER
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201804/01/1987
(262) 896-8046
(262) [email protected] LEWIS
County: WaukeshaWAUKESHA, WI 531881501 AIRPORT ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 05/01/2018 04/30/2020
MENTAL HEALTH-INPATIENT DHS 61.71 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
1970WAUKESHA COUNTY, DBA WAUKESHA COUNTY DHHS
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/201905/01/201704/01/1984
(262) 548-7656
(262) [email protected] OWLEY
County: WaukeshaWAUKESHA, WI 53188514 RIVERVIEW AVENUE
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2017 04/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 05/01/2017 04/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 05/01/2017 04/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier05/01/2017 04/30/2019WAUKESHA COUNTY MENTAL HEALTH CENTER, 1501 AIRPORT RD, WAUKESHA, WI 531882
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Substance Abuse Program Directory By County, City, and Provider Name
1976WAUKESHA MEMORIAL HOSPITAL
Surveyor: Anastasia E. Vega
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201706/01/1986
(262) 928-8126
(262) [email protected] GRZYBOWSKI
County: WaukeshaWAUKESHA, WI 53188725 AMERICAN AVENUE
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 01/01/2017 12/31/2018
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 01/01/2017 12/31/2018
CSAS-MEDICALLY MANAGED INPATIENT TREATMENT DHS 75.10 01/01/2017 12/31/2018
MENTAL HEALTH-DAY TREATMENT DHS 61.75 01/01/2017 12/31/2018
MENTAL HEALTH-INPATIENT DHS 61.71 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WAUPACAWAUPACA
2123WAUPACA COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201812/01/1981
(715) 258-6409
(715) [email protected] NICHOLS
County: WaupacaWAUPACA, WI 54981811 HARDING STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
3109WAUPACA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201901/01/201803/01/2016
(715) 258-6409
(715) [email protected] NICHOLS
County: WaupacaWAUPACA, WI 54981811 HARDING ST
CCS Affiliaton: 01/01/2016Begin: End: Lead:Central Wisconsin Health Partnership V2
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 01/01/2018 12/31/2019
Services
NO BRANCH LOCATIONS
1977WAUPACA COUNTY DEPT OF HEALTH AND HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/201907/01/201712/01/1981
(715) 258-6409
(715) [email protected] NICHOLS
County: WaupacaWAUPACA, WI 54981811 HARDING STREET
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 07/01/2017 06/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2017 06/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2017 06/30/2019
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 07/01/2017 06/30/2019
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2017 06/30/2019WAUPACA CO DEPT OF HEALTH & HUMAN SERV, 1405 MILL ST, NEW LONDON, WI 549611
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Substance Abuse Program Directory By County, City, and Provider Name
WAUSHARAWAUTOMA
3191FAMILY HEALTH LA CLINICA
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/05/201803/05/2018
(920) 787-4737
(920) [email protected] AMBROSIUS
County: WausharaWAUTOMA, WI 54982400 SOUTH TOWNLINE ROAD
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/05/2018 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/05/2018 02/28/2019
Services
NO BRANCH LOCATIONS
1980WAUSHARA COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201610/01/1975
(920) 787-0421
(920) [email protected] MORGAN-JONES
County: WausharaWAUTOMA, WI 54982230 W PARK STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
CSAS-PREVENTION DHS 75.04 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 11/01/2016 10/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier11/01/2016 10/31/2018BERLIN HIGH SCHOOL, 222 MEMORIAL DRIVE, BERLIN, WI 549233
11/01/2016 10/31/2018TRI-COUNTY HIGH SCHOOL, 409 S WEST STREET, PLAINFIELD, WI 549663
11/01/2016 10/31/2018WAUTOMA HIGH SCHOOL, 514 S CAMBRIDGE STREET, WAUTOMA, WI 549823
11/01/2016 10/31/2018WESTFIELD AREA MIDDLE/HIGH SCHOOL, N 7046 COUNTY ROAD CH, WESTFIELD, WI 539643
11/01/2016 10/31/2018WILD ROSE SCHOOL DISTRICT, 600 PARK AVE, WILD ROSE, WI 549843
1979WAUSHARA COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201608/01/1997
(920) 787-0421
(920) [email protected] MORGAN-JONES
County: WausharaWAUTOMA, WI 54982230 W PARK STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
2618WAUSHARA COUNTY HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201610/19/2005
(920) 787-0421
(920) [email protected] MORGAN-JONES
County: WausharaWAUTOMA, WI 54982230 W PARK STREET
CCS Affiliaton: 09/01/2014 12/31/2015Begin: End: Lead:Central Wisconsin Health Partnership
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
06/26/2018 Page 165 of 172
Substance Abuse Program Directory By County, City, and Provider Name
WINNEBAGOMENASHA
1355THE SAMARITAN COUNSELING CENTER OF THE FOX VALLEY
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 02/28/201903/01/201703/01/1983
(920) 886-9357
(920) [email protected] BERBERT
County: WinnebagoMENASHA, WI 549521478 KENWOOD DRIVE SUITE 1
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 03/01/2017 02/28/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 03/01/2017 02/28/2019
Services
Branch Begin/End DatesBranch Location(s)Tier03/01/2017 02/28/2019PROJECT OPEN DOOR IMMANUEL UNITED CHURCH, 510 SULLIVAN AVENUE, KAUKAUNA, WI 541301
03/01/2017 02/28/2019THE SAMARITAN COUNSELING CTR FOX VALLEY, 1478 MIDWAY ROAD, MENASHA, WI 549521
03/01/2017 02/28/2019THE SAMARITAN COUNSELING CTR FOX VALLEY, 110 CHURCH AVENUE, OSHKOSH, WI 549012
03/01/2017 02/28/2019THE SAMARITAN COUNSELING CTR FOX VALLEY, 709 W PINE STREET, NEW LONDON, WI 549612
2052THEDACARE BEHAVIORAL HEALTH
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/31/1998
(920) 720-3719
(920) [email protected] PAGEL
County: WinnebagoMENASHA, WI 549521095 MIDWAY ROAD
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH-DAY TREATMENT DHS 61.75 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020THEDACARE BEHAVIORAL HEALTH, 1405 MILL STREET, NEW LONDON, WI 549611
07/01/2018 06/30/2020THEDACARE BEHAVIORAL HEALTH, 100 COUNTY ROAD B, SHAWANO, WI 541662
07/01/2018 06/30/2020THEDACARE BEHAVIORAL HEALTH, 2500 E CAPITAL DRIVE, APPLETON, WI 549112
07/01/2018 06/30/2020THEDACARE BEHAVIORAL HEALTH, 333 GREEN BAY RD, NEENAH, WI 549562
07/01/2018 06/30/2020THEDACARE BEHAVIORAL HEALTH, 600 N WESTHAVEN DRIVE, OSHKOSH, WI 549012
07/01/2018 06/30/2020THEDACARE BEHAVIORAL HEALTH, 902 RIVERSIDE DRIVE, #204, WAUPACA, WI 549812
NEENAH
2968ESPRIT COUNSELING AND CONSULTING
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201807/26/2012
(920) 243-0341
(920) [email protected] JO LARSON
County: WinnebagoNEENAH, WI 5495640 JEWELERS PARK DRIVE #200
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1946THEDACARE BEHAVIORAL HEALTH AT THEDA CLARK MEDICAL CENTER
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201703/01/1983
(920) 729-2906
(920) [email protected] BUTTS
County: WinnebagoNEENAH, WI 54956130 SECOND STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 02/01/2017 01/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
2006WINNEBAGO COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201607/01/1988
(920) 720-9682
(920) [email protected] DAEHN PHD
County: WinnebagoNEENAH, WI 54956211 N COMMERCIAL STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
2278WINNEBAGO COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201611/01/2000
(920) 720-9682
(920) [email protected] AMOS
County: WinnebagoNEENAH, WI 54956211 N. COMMERCIAL STREET
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
OSHKOSH
3089AMS OF WISCONSIN, LLC - OSHKOSH
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201911/01/201609/04/2015
(920) 232-2342
(920) [email protected] WESTPHAL
County: WinnebagoOSHKOSH, WI 54904505 S WASHBURN STREET
Service Begin/End DatesAdm Code
CSAS-NARCOTIC TREATMENT DHS 75.15 11/01/2016 09/30/2019
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 09/30/2019
Services
NO BRANCH LOCATIONS
3004GENESIS BEHAVIORAL SVCS OSHKOSH RESIDENTIAL PROGRAM
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201709/23/2013
(920) 235-0336
(414) [email protected] SANCHEZ
County: WinnebagoOSHKOSH, WI 54901304 OTTER AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 09/01/2017 08/31/2019
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
1613MERCY COUNSELING SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201702/01/1995
(920) 236-8591
(920) [email protected] MCGLYNN
County: WinnebagoOSHKOSH, WI 549042700 W9TH AVE STE 102
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2017 08/31/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2017 08/31/2019
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2017 08/31/2019CATALPA HEALTH - AFFINITY BEHAVORIAL HEALTH, 444 N WESTHILL BLVD, APPLETON, WI 549141
1608MERCY MEDICAL CENTER
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201909/01/201702/01/1982
(920) 223-3404
(920) [email protected] MCGLYNN
County: WinnebagoOSHKOSH, WI 54904500 S OAKWOOD ROAD
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MANAGED INPATIENT DETOX DHS 75.06 09/01/2017 08/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 09/01/2017 08/31/2019
Services
NO BRANCH LOCATIONS
1710NOVA COUNSELING SERVICES, INC
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 04/30/202005/01/201811/01/1985
(920) 231-4246
(920) [email protected] WILLEFORD
County: WinnebagoOSHKOSH, WI 549013240 JACKSON STREET
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 05/01/2018 04/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 05/01/2018 04/30/2020
CSAS-TRANSITIONAL RESIDENTIAL DHS 75.14 05/01/2018 04/30/2020
Services
NO BRANCH LOCATIONS
2007WINNEBAGO COUNTY DEPARTMENT OF HUMAN SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201610/01/1975
(920) 236-1157
(920) [email protected] DAEHN
County: WinnebagoOSHKOSH, WI 54903220 WASHINGTON AVENUE
Service Begin/End DatesAdm Code
CSAS-EMERGENCY OUTPATIENT DHS 75.05 11/01/2016 10/31/2018
CSAS-OUTPATIENT TREATMENT DHS 75.13 11/01/2016 10/31/2018
CSAS-PREVENTION DHS 75.04 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 11/01/2016 10/31/2018
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2266WINNEBAGO COUNTY DEPARTMENT OF HUMAN SERVICES CSP
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201811/01/201610/01/1975
(920) 236-1157
(920) [email protected] HOODIE
County: WinnebagoOSHKOSH, WI 54903220 WASHINGTON AVENUE
Service Begin/End DatesAdm Code
MENTAL HEALTH-COMMUNITY SUPPORT PROGRAM DHS 63 11/01/2016 10/31/2018
Services
NO BRANCH LOCATIONS
2579WINNEBAGO COUNTY DHS COMPREHENSIVE COMMUNITY SERVICES
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 03/31/201904/01/201703/09/2005
(920) 303-4792
(920) [email protected] DAEHN PHD
County: WinnebagoOSHKOSH, WI 54903220 WASHINGTON AVENUE
CCS Affiliaton: 09/01/2014Begin: End: Lead:Northeastern Region CCS Consortium
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 04/01/2017 03/31/2019
Services
NO BRANCH LOCATIONS
WINNEBAGO
2008WINNEBAGO MENTAL HEALTH INSTITUTE
Surveyor: Heather Schweiner
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 10/31/201911/01/201710/01/1975
(920) 237-2043
(920) [email protected] SPEECH
County: WinnebagoWINNEBAGO, WI 54985TREFFERT DRIVE & BUTLER AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED TREATMENT DHS 75.11 11/01/2017 10/31/2019
MENTAL HEALTH-ADOLESCENT INPATIENT DHS 61.79 11/01/2017 10/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 11/01/2017 10/31/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
WINONAWINONA
2823HIAWATHA VALLEY MENTAL HEALTH CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 08/31/201809/01/201609/21/2009
(507) 453-6267
(507) [email protected] HANSON
County: WinonaWINONA, MN 55987166 MAIN STREET
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 09/01/2016 08/31/2018
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 09/01/2016 08/31/2018
Services
Branch Begin/End DatesBranch Location(s)Tier09/01/2016 08/31/2018HIAWATHA VALLEY MENTAL HEALTH CENTER, 313 4TH ST. S, LA CROSSE, WI 546011
09/01/2016 08/31/2018HIAWATHA VALLEY MENTAL HEALTH CENTER, 611 BROADWAY AVENUE, #100, WABASHA, MN 55981
1
09/01/2016 08/31/2018HIAWATHA VALLEY MENTAL HEALTH CENTER, 2835 S. SERVICE DR., STE. 103, RED WING, MN 55066
2
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Substance Abuse Program Directory By County, City, and Provider Name
WOODMARSHFIELD
3135MARSHFIELD CLINIC CENTER FOR COMMUNITY OUTREACH
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201710/01/2016
(715) 389-8779
(715) [email protected] LUTHER
County: WoodMARSHFIELD, WI 544491701 N FIG AVE
Service Begin/End DatesAdm Code
CSAS-PREVENTION DHS 75.04 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
1709NORWOOD HEALTH CENTER
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 01/31/201902/01/201704/01/1980
(715) 389-2266
(715) [email protected] BRUCE
County: WoodMARSHFIELD, WI 544491600 N. CHESTNUT AVENUE
Service Begin/End DatesAdm Code
CSAS-MEDICALLY MONITORED RESIDENTIAL DETOX DHS 75.07 02/01/2017 01/31/2019
MENTAL HEALTH-INPATIENT DHS 61.71 02/01/2017 01/31/2019
Services
NO BRANCH LOCATIONS
3078OLSON PROFESSIONAL COUNSELING SERVICES LLC
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 12/31/201801/01/201701/05/2015
(715) 384-7881
(715) [email protected] OLSON
County: WoodMARSHFIELD, WI 54449252 S CENTRAL AVE STE 24
Service Begin/End DatesAdm Code
CSAS-OUTPATIENT TREATMENT DHS 75.13 01/01/2017 12/31/2018
Services
NO BRANCH LOCATIONS
WISCONSIN RAPIDS
1208CLINICAL SERVICES
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 09/30/201910/01/201710/01/1988
(715) 424-3441
(715) [email protected] MICHAEL J NELSON
County: WoodWISCONSIN RAPIDS, WI 54495420 - 1ST AVENUE SOUTH
Service Begin/End DatesAdm Code
CSAS-INTERVENTION DHS 75.16 10/01/2017 09/30/2019
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 10/01/2017 09/30/2019
Services
NO BRANCH LOCATIONS
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Substance Abuse Program Directory By County, City, and Provider Name
2678WOOD COUNTY HUMAN SERVICES CCS
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201808/01/1977
(715) 421-2266
(715) [email protected] SCHEIDEGGER
County: WoodWISCONSIN RAPIDS, WI 54494111 W JACKSON ST
CCS Affiliaton: 09/01/2014Begin: End: Lead:Portage Wood Partnership
Service Begin/End DatesAdm Code
CCS REGIONAL MODEL SHARED SERVICES DHS 36 07/01/2018 06/30/2020
Services
NO BRANCH LOCATIONS
2019WOOD COUNTY HUMAN SERVICES DEPARTMENT
Surveyor: Roderick Senn
Initial Cert:Cert Eff:Cert Exp:
Fax:
Phone: 06/30/202007/01/201808/01/1977
(715) 421-2266
(715) [email protected] SCHUELER SHEVELAND
County: WoodWISCONSIN RAPIDS, WI 54494111 W JACKSON ST
Service Begin/End DatesAdm Code
CSAS-DAY TREATMENT DHS 75.12 07/01/2018 06/30/2020
CSAS-DAY TREATMENT WITH TELEHEALTH DHS 75.12 07/01/2018 06/30/2020
CSAS-EMERGENCY OUTPATIENT DHS 75.05 07/01/2018 06/30/2020
CSAS-EMERGENCY OUTPATIENT WITH TELEHEALTH DHS 75.05 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT DHS 75.13 07/01/2018 06/30/2020
CSAS-OUTPATIENT TREATMENT WITH TELEHEALTH DHS 75.13 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH OUTPATIENT CLINIC WITH TELEHEALTH DHS 35 07/01/2018 06/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 DHS 34.3 07/01/2018 06/30/2020
MENTAL HEALTH-EMERGENCY SERVICE 3 W/TELEHEALTH DHS 34.3 07/01/2018 06/30/2020
Services
Branch Begin/End DatesBranch Location(s)Tier07/01/2018 06/30/2020NORWOOD HEALTH CARE BRANCH OFFICE, 1600 NORTH CHESTNUT, MARSHFIELD, WI 544492
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