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 142 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2957 JACKSON COUNTY DEPT OF HEALTH & HUMAN SERVICES BETH SMETANA 420 HIGHWAY 54 WEST BLACK RIVER FALLS, WI 54615 County: Jackson beth.smetana@co.jackson.wi.us Phone: (715) 284-4301 Fax: (715) 284-7713 Surveyor: Polly Wong Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 01/01/2012 01/01/2012 12/31/2012 CSAS-Intervention DHS 75.16 1448 JANESVILLE PSYCHIATRIC CLINIC BILL HOLLINGSWORTH 15 WEST MILWAUKEE ST SUITE #207 JANESVILLE, WI 53548 County: Rock janesvillepsych@sbcglobal.net Phone: (608) 755-1475 Fax: (608) 755-1733 Surveyor: William Rohner 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 10/01/1981 12/01/2011 11/30/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 2221 JEFFERSON COUNTY HUMAN SERVICES COMMUNITY SUPPORT PROGRAM MAJORIE THORMAN 1541 ANNEX ROAD JEFFERSON, WI 53549 County: Jefferson marjt@jeffersoncountywi.gov Phone: (920) 674-8198 Fax: (920) 674-7409 Surveyor: Demetrius Anderson Services NO BRANCH LOCATIONS 01/01/2012 12/31/2012 Administrative Code Chapter Service Begin/End Dates 06/01/2000 06/01/2012 05/31/2014 Mental Health-Community Support Program DHS 63 NO BRANCH LOCATIONS 12/01/2011 11/30/2013 12/01/2011 11/30/2013 Administrative Code Chapter Service Begin/End Dates 06/01/2012 05/31/2014
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 143 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2643 JEFFERSON COUNTY HUMAN SERVICES COMPREHENSIVE COMMUNITY SERVICES KIMBERLY PROPP 1541 ANNEX ROAD JEFFERSON, WI 53549 County: Jefferson kimp@jeffersoncountywi.gov Phone: (920) 674-8727 Fax: (920) 674-2359 Surveyor: Demetrius Anderson Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 02/15/2006 03/01/2011 02/28/2013 Comprehensive Community Services (CCS) DHS 36 1449 JEFFERSON COUNTY HUMAN SERVICES HOLLY PAGEL 1541 ANNEX ROAD JEFFERSON, WI 53549 County: Jefferson hollyp@jeffersoncountywi.gov Phone: (920) 674-3105 Fax: (920) 674-6113 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 10/01/1975 06/01/2012 05/31/2014 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 Mental Health-Emergency Service 3 DHS 34.3 1450 JEWISH FAMILY SERVICES JAMES WELSCH 1300 N. JACKSON STREET MILWAUKEE, WI 53202 County: Milwaukee jwelsch@jfsmilw.org Phone: (414) 390-5899 Fax: (414) 225-1346 Surveyor: William Goehring Services NO BRANCH LOCATIONS 03/01/2011 02/28/2013 Administrative Code Chapter Service Begin/End Dates 06/01/1979 06/01/2012 05/31/2014 Mental Health Outpatient Clinic DHS 35 06/01/2012 05/31/2014 06/01/2012 05/31/2014 06/01/2012 05/31/2014 JEWISH FAMILY SERVICES Tier 1 5800 N BAYSHORE DRIVE 06/01/2012 GLENDALE, WI 53209 05/31/2014 Administrative Code Chapter Service Begin/End Dates 06/01/2012 05/31/2014
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Mental Health and Substance Abuse Programs in alphabetical

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