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 141 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
2347<br />
IRON COUNTY HUMAN SERVICES DEPARTMENT<br />
AND ASSOCIATES<br />
CAROLYN KOLSON-JANOV<br />
300 TACONITE STREET, #201<br />
HURLEY, WI 54534<br />
County: Iron<br />
kolsonc@ironcountywi.org<br />
Phone: (715) 561-3636<br />
Fax: (715) 561-2128<br />
Surveyor: Bradley Jahr<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 />
03/01/2002<br />
03/01/2011<br />
02/28/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic with Telehealth DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
CSAS-Outpatient Treatment with Telehealth DHS 75.13<br />
CSAS-Prevention DHS 75.04<br />
CSAS-Prevention with Telehealth DHS 75.04<br />
1446<br />
JACKIE NITSCHKE CENTER, INC.<br />
WILLIAM LABINE<br />
630 CHERRY STREET<br />
GREEN BAY, WI 54301<br />
County: Brown<br />
wlab<strong>in</strong>e@jackienitschkecenter.com<br />
Phone: (920) 435-2093<br />
Fax: (920) 435-2580<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 />
IRON COUNTY HUMAN SERVICES DEPT<br />
& ASSOC<br />
2567 RAILROAD STREET<br />
MERCER, WI 54547<br />
Tier 1<br />
03/01/2011<br />
02/28/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
06/05/1990<br />
01/01/2011<br />
12/31/2012<br />
CSAS-Medically Monitored Treatment DHS 75.11<br />
CSAS-Outpatient Treatment DHS 75.13<br />
2901<br />
JACKSON COUNTY DEPARTMENT OF HEALTH<br />
AND HUMAN SERVICES<br />
CHRISTINE HOVELL<br />
420 HIGHWAY 54 WEST<br />
BLACK RIVER FALLS, WI 54615<br />
County: Jackson<br />
Beth.smetana@co.jackson.wi.us<br />
Phone: (715) 284-4301<br />
Fax: (715) 284-7713<br />
Surveyor: Polly Wong<br />
Services<br />
NO BRANCH LOCATIONS<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
05/01/2010<br />
05/01/2012<br />
04/30/2014<br />
<strong>Mental</strong> <strong>Health</strong>-Emergency Service 3 DHS 34.3<br />
NO BRANCH LOCATIONS<br />
01/01/2011 12/31/2012<br />
01/01/2011 12/31/2012<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
05/01/2012 04/30/2014
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