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 178 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1560 MARQUETTE CHEMICAL DEPENDENCY SERVICES BRUCE NICHOLAS 428 UNDERWOOD AVE MONTELLO, WI 53949 County: Marquette B.nicholashh@gmail.com Phone: (608) 297-2085 Fax: (608) 297-2426 Surveyor: William Goehring Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 03/01/1981 05/01/2012 04/30/2014 CSAS-Emergency Outpatient DHS 75.05 CSAS-Outpatient Treatment DHS 75.13 CSAS-Prevention DHS 75.04 2424 MARRIAGE & FAMILY HEALTH SERVICES, LTD. THOMAS JOHNSTON 405 ISLAND STREET CHIPPEWA FALLS, WI 54729 County: Chippewa chippewafallsmikan@att.net Phone: (715) 726-9208 Fax: (715) 726-8731 Surveyor: Polly Wong 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 01/01/2003 05/01/2012 04/30/2014 Mental Health-Day Treatment for Children 1 DHS 40.11(2)(a) 2738 MARRIAGE & FAMILY SOLUTIONS LLC CRYSTAL DALEBROUX 7818 BIG SKY DRIVE, #101 MADISON, WI 53719 County: Dane marriage.solutions@sbcglobal.net Phone: (608) 203-6267 Fax: (608) 203-6696 Surveyor: William Rohner Services NO BRANCH LOCATIONS 05/01/2012 04/30/2014 05/01/2012 04/30/2014 05/01/2012 04/30/2014 Administrative Code Chapter Service Begin/End Dates 06/08/2007 06/01/2011 05/31/2013 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 05/01/2012 04/30/2014 Administrative Code Chapter Service Begin/End Dates 06/01/2011 05/31/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 179 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1562 MARRIAGE AND FAMILY HEALTH SERVICES, LTD. THOMAS JOHNSTON 2925 MONDOVI ROAD EAU CLAIRE, WI 54701 County: Eau Claire ecmikan@sbcglobal.net Phone: (715) 832-0238 Fax: (715) 832-0771 Surveyor: Polly Wong Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 09/01/1983 05/01/2012 04/30/2014 Mental Health Outpatient Clinic DHS 35 STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates MARRIAGE & FAMILY HEALTH SVS Tier 1 104 WEST WASHINGTON AVE 09/02/2012 BRUCE, WI 54819 04/30/2014 MARRIAGE & FAMILY HEALTH SVS Tier 1 604 7TH AVE EAST 05/01/2012 DURAND, WI 54736 04/30/2014 MARRIAGE & FAMILY HEALTH SVS Tier 1 1700 EDGEWOOD AVE EAST 05/01/2012 LADYSMITH, WI 54848 04/30/2014 MARRIAGE & FAMILY HEALTH SVS Tier 1 500 MAIN ST 05/01/2012 EAU CLAIRE, WI 54701 04/30/2014 MARRIAGE & FAMILY HEALTH SVS Tier 1 1130 MILES ST 05/01/2012 CHIPPEWA FALLS, WI 54729 04/30/2014 MARRIAGE & FAMILY HEALTH SVS Tier 1 W21772 US HWY 10 05/01/2012 STRUM, WI 54770 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES LTD Tier 1 905 - 7TH AVE WEST 05/01/2012 DURAND, WI 54736 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES LTD Tier 1 250 BUFFALO STREET 05/01/2012 MONDOVI, WI 54755 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES, LTD Tier 1 1301 COULEE ROAD 05/01/2012 HUDSON, WI 54016 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES, LTD Tier 1 612 E WARDEN AVENUE 05/01/2012 LADYSMITH, WI 54848 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES, LTD. Tier 1 P O BOX 517407 S 2ND STREET 05/01/2012 ALMA, WI 54610 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES, LTD. Tier 1 1109 HEART ISLAND PARKWAY 05/01/2012 RICE LAKE, WI 54868 04/30/2014 MARRIAGE AND FAMILY HEALTH SERVICES, LTD. Tier 1 132 W COLUMBIA STREET 05/01/2012 CHIPPEWA FALLS, WI 54729 04/30/2014 Administrative Code Chapter Service Begin/End Dates 05/01/2012 04/30/2014
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Mental Health and Substance Abuse Programs in alphabetical

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