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 207 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1654<br />
MONROE COUNTY DEPARTMENT OF HUMAN<br />
SERVICES<br />
SUSAN RETTLER<br />
14301 HWY B, COMM SVS CTR A-19<br />
SPARTA, WI 54656<br />
County: Monroe<br />
srettler@co.monroe.wi.us<br />
Phone: (608) 269-8630<br />
Fax: (608) 269-8935<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 />
10/01/1975<br />
12/01/2010<br />
11/30/2012<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Emergency Outpatient DHS 75.05<br />
CSAS-Outpatient Treatment DHS 75.13<br />
<strong>Mental</strong> <strong>Health</strong>-Emergency Service 3 DHS 34.3<br />
2613<br />
MOORE AND ASSOCIATES/BIRDS OF A FEATHER,<br />
INC.<br />
TONY MOORE<br />
6530 SHERIDAN ROAD, #3<br />
KENOSHA, WI 53143<br />
County: Kenosha<br />
Tmoore@moore<strong>and</strong>associates.biz<br />
Phone: (262) 605-1444<br />
Fax: (262) 605-1404<br />
Surveyor: Mark Isaacs<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 />
09/14/2005<br />
04/01/2012<br />
09/30/2013<br />
CSAS-Day Treatment DHS 75.12<br />
CSAS-Outpatient Treatment DHS 75.13<br />
1917<br />
MOORING PROGRAMS, INC.<br />
JAMIE LOEHNIS<br />
607 W. SEVENTH STREET<br />
APPLETON, WI 54911<br />
County: Outagamie<br />
Jamie@moor<strong>in</strong>gcasa.com<br />
Phone: (920) 739-3235<br />
Fax: (920) 731-4796<br />
Surveyor: Frank Bellaire<br />
Services<br />
MOORE AND ASSOC, INC/HARVEST<br />
CONSULTING<br />
2405 NORTHWESTERN AVENUE, #105<br />
RACINE, WI 53404<br />
12/01/2010 11/30/2012<br />
12/01/2010 11/30/2012<br />
12/01/2010 11/30/2012<br />
12/01/2010 11/30/2012<br />
Tier 1<br />
04/01/2012<br />
09/30/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
05/08/1991<br />
07/01/2012<br />
06/30/2014<br />
CSAS-Emergency Outpatient DHS 75.05<br />
CSAS-Medically Monitored Treatment DHS 75.11<br />
CSAS-Outpatient Treatment DHS 75.13<br />
CSAS-Residential Intoxication Monitor<strong>in</strong>g DHS 75.09<br />
CSAS-Transitional Residential DHS 75.14<br />
NO BRANCH LOCATIONS<br />
04/01/2012 09/30/2013<br />
04/01/2012 09/30/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
07/01/2012 06/30/2014<br />
07/01/2012 06/30/2014<br />
07/01/2012 06/30/2014<br />
07/01/2012 06/30/2014<br />
07/01/2012 06/30/2014
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