Mental Health and Substance Abuse Programs in alphabetical

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DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 112 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2730 GENESIS BEHAVIORAL SERVICES, INC. SPRING PLACE GINA SINGLETERY 4107-09 ST CLAIR STREET RACINE, WI 53402 County: Racine Gina.Singletery@corizonhealth.com Phone: (262) 633-3889 Fax: (262) 633-5626 Surveyor: Demetrius Anderson Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 04/09/2007 05/01/2011 04/30/2013 CSAS-Transitional Residential DHS 75.14 1465 GENESIS BEHAVIORAL SERVICES, INC. WEST BEND OUTPATIENT CLINIC GINA SINGLETERY 1626 CLARENCE COURT WEST BEND, WI 53095 County: Washington Gina.singletery@corizonhealth.com Phone: (414) 777-1570 Fax: (414) 777-1565 Surveyor: William Goehring Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates NO BRANCH LOCATIONS Administrative Code Chapter Service Begin/End Dates 01/01/1987 01/01/2012 12/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Day Treatment DHS 75.12 CSAS-Outpatient Treatment DHS 75.13 05/01/2011 04/30/2013 GENESIS BEHAVIORAL SERVICES, INC Tier 2 500 N SCHMIDT ROAD 01/01/2012 WEST BEND, WI 53095 12/31/2013 GENESIS BEHAVIORAL SERVICES, INC Tier 2 400 UNIVERSITY DRIVE 01/01/2012 WEST BEND, WI 53095 12/31/2013 GENESIS BEHAVIORAL SERVICES, INC Tier 1 W175 N11163 STONEWOOD DRIVE, #208 01/01/2012 GERMANTOWN, WI 53022 12/31/2013 GENESIS COMP WOMEN'S RECOVERY PROGRAM Tier 1 279 S 17TH AVENUE 01/01/2012 WEST BEND, WI 53095 01/01/2012 Administrative Code Chapter Service Begin/End Dates 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 113 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1381 GENESIS COUNSELING SERVICES, LTD. JAMES BURNS PHD ONE S. MAIN STREET JANESVILLE, WI 53545 County: Rock jburns@gencounseling.com Phone: (608) 757-0404 Fax: (608) 757-2319 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/01/1988 07/01/2011 06/30/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 1462 GENESIS DETOXIFICATION CENTER GINA SINGLETERY 2835 N 32ND STREET MILWAUKEE, WI 53210 County: Milwaukee gina.singletery@corizonhealth.com Phone: (414) 342-6200 Fax: (414) 342-4480 Surveyor: Demetrius Anderson Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates NO BRANCH LOCATIONS Administrative Code Chapter Service Begin/End Dates 07/01/1988 07/01/2011 06/30/2013 CSAS-Ambulatory Detoxification DHS 75.08 CSAS-Medically Monitored Residential Detox DHS 75.07 CSAS-Medically Monitored Treatment DHS 75.11 CSAS-Residential Intoxication Monitoring DHS 75.09 1382 GENESIS HOUSE - LUTHERAN SOCIAL SERVICES DEBRA ADAMUS 1002 MOTOR AVENUE WAUKESHA, WI 53188 County: Waukesha debra.adamus@lsswis.org Phone: (262) 544-0711 Fax: (262) 544-1322 Surveyor: Mark Isaacs Services NO BRANCH LOCATIONS 07/01/2011 06/30/2013 07/01/2011 06/30/2013 Administrative Code Chapter Service Begin/End Dates 07/01/1994 07/01/2012 06/30/2014 CSAS-Transitional Residential DHS 75.14 NO BRANCH LOCATIONS 07/01/2011 04/10/2012 07/01/2011 06/30/2013 07/01/2011 06/30/2013 07/01/2011 06/30/2013 Administrative Code Chapter Service Begin/End Dates 07/01/2012 06/30/2014
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