Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
DEPARTMENT OF HEALTH SERVICES<br />
Division of Quality Assurance<br />
Pr<strong>in</strong>t Date: 08/28/2012<br />
Page 186 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1362<br />
MAYO CLINIC HEALTH SYSTEM - FRANCISCAN<br />
MEDICAL CENTER, INC.<br />
ROBERT HILARY<br />
212 S. 11TH STREET<br />
LA CROSSE, WI 54601<br />
County: La Crosse<br />
Hillary.Robert@mayo.edu<br />
Phone: (608) 791-9555<br />
Fax: (608) 791-9793<br />
Surveyor: Polly Wong<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 />
09/01/1977<br />
02/01/2012<br />
05/31/2013<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 />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment DHS 61.75<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 />
MAYO CLINIC FRANCISCAN - GERARD<br />
HALL<br />
940 DIVISION STREET<br />
LA CROSSE, WI 54601<br />
MAYO CLINIC FRANCISCAN - HOLMEN<br />
CLINIC<br />
1303 MAIN STREET<br />
HOLMEN, WI 54636<br />
MAYO CLINIC FRANCISCAN - ONALASKA<br />
CLINIC<br />
191 THEATER ROAD<br />
ONALASKA, WI 54650<br />
MAYO CLINIC FRANCISCAN - PRAIRIE DU<br />
CHIEN CLINIC<br />
800 E BLACKHAWK AVENUE<br />
PRAIRIE DU CHIEN, WI 53821<br />
MAYO CLINIC FRANCISCAN - SCARSETH<br />
HOUSE<br />
535 S 17TH STREET<br />
LA CROSSE, WI 54601<br />
MAYO CLINIC FRANCISCAN - SIENA<br />
HALL<br />
608 S 11TH STREET<br />
LA CROSSE, WI 54601<br />
MAYO CLINIC FRANCISCAN - VILLA<br />
SUCCES<br />
121 PRAIRIE STREET<br />
PRAIRIE DU CHIEN, WI 53821<br />
MAYO CLINIC FRANCISCAN - WOMEN'S<br />
LAAR HOUSE<br />
1005 JACKSON STREET<br />
LA CROSSE, WI 54601<br />
MAYO CLINIC FRANCISCAN MEDICAL<br />
CENTER<br />
700 WEST AVENUE SOUTH<br />
LA CROSSE, WI 54601<br />
MAYO CLINIC FRANCISCAN MEDICAL<br />
CENTER<br />
800 WEST AVENUE SOUTH<br />
LA CROSSE, WI 54601<br />
Tier 1<br />
02/01/2012<br />
05/31/2013<br />
Tier 2<br />
02/01/2012<br />
05/31/2013<br />
Tier 2<br />
02/01/2012<br />
05/31/2013<br />
Tier 2<br />
02/01/2012<br />
05/31/2013<br />
Tier 1<br />
02/01/2012<br />
05/31/2013<br />
Tier 1<br />
02/01/2012<br />
05/31/2013<br />
Tier 1<br />
02/01/2012<br />
05/31/2013<br />
Tier 1<br />
02/01/2012<br />
05/31/2013<br />
Tier 2<br />
02/01/2012<br />
05/31/2013<br />
Tier 2<br />
02/01/2012<br />
05/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
02/01/2012 05/31/2013<br />
02/01/2012 05/31/2013<br />
02/01/2012 05/31/2013<br />
02/01/2012 05/31/2013
Change language