Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
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DEPARTMENT OF HEALTH SERVICES<br />
Division of Quality Assurance<br />
Pr<strong>in</strong>t Date: 08/28/2012<br />
Page 139 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
2628<br />
INTEGRATED COUNSELING CENTER, LLC<br />
ROSONNA S COMERS<br />
N6687 WRIGHTWAY DRIVE #D<br />
FOND DU LAC, WI 54937<br />
County: Fond Du Lac<br />
<strong>in</strong>tegratedcounsel<strong>in</strong>gcenter@yahoo.com<br />
Phone: (920) 929-9140<br />
Fax: (920) 929-9142<br />
Surveyor: William Goehr<strong>in</strong>g<br />
Services<br />
Community <strong>Substance</strong> <strong>Abuse</strong> <strong>and</strong> <strong>Mental</strong> <strong>Health</strong><br />
Program Certification Directory<br />
By Provider Name & Certification Number<br />
Initial Certification/<br />
Certification Effective/<br />
Certification Expires<br />
12/14/2005<br />
01/01/2010<br />
12/31/2011<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
2843<br />
INTEGRATED COUNSELING CENTER, LLC<br />
ROSONNA S COMMERS<br />
404 N MAIN STREET #612<br />
OSHKOSH, WI 54901<br />
County: W<strong>in</strong>nebago<br />
iccllc@sbcglobal.net<br />
Phone: (920) 651-9264<br />
Fax: (920) 651-9265<br />
Surveyor: Frank Bellaire<br />
Services<br />
STATE OF WISCONSIN<br />
Bureau of <strong>Health</strong> Services<br />
PO Box 2969<br />
Madison, WI 53701-2969<br />
Tier/<br />
Branch Beg<strong>in</strong>/<br />
Branch Location(s) End Dates<br />
NO BRANCH LOCATIONS<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
05/22/2009<br />
05/22/2009<br />
06/30/2010<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
<strong>Mental</strong> <strong>Health</strong>-Outpatient DHS 61.91<br />
2392<br />
INTEGRATED DEVELOPMENT SERVICES, INC.<br />
SAM GARLOCK<br />
6506 SCHROEDER ROAD<br />
MADISON, WI 53711<br />
County: Dane<br />
sgarlock@ids-wi.com<br />
Phone: (608) 441-0123<br />
Fax: (608) 441-0126<br />
Surveyor: William Rohner<br />
Services<br />
NO BRANCH LOCATIONS<br />
01/01/2010 12/31/2011<br />
01/01/2010 12/31/2011<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
09/01/2002<br />
09/01/2010<br />
08/31/2012<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
06/01/2009 06/30/2010<br />
05/22/2009 06/30/2010<br />
05/22/2009 05/31/2009<br />
INTEGRATED DEVELOPMENT SERVICES Tier 2<br />
762 LOIS DRIVE<br />
09/01/2011<br />
SUN PRAIRIE, WI 53590<br />
08/31/2012<br />
INTEGRATED DEVELOPMENT SERVICES Tier 2<br />
815 FORWARD DRIVE<br />
06/27/2012<br />
MADISON, WI 53711<br />
08/31/2012<br />
INTEGRATED DEVELOPMENT SERVICES Tier 2<br />
2525 N MAYFAIR RD<br />
06/27/2012<br />
WAUWATOSA, WI 53226<br />
08/31/2012<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
09/01/2010 08/31/2012
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