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 223 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
2655<br />
NORTHWEST JOURNEY - BLACK RIVER FALLS<br />
JEN STEINKE<br />
N6643 COUNTY ROAD A<br />
BLACK RIVER FALLS, WI 54615<br />
County: Jackson<br />
NWJBlackRiverFalls@nwcgc.com<br />
Phone: (715) 284-1100<br />
Fax: (715) 284-1145<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 />
02/01/2006<br />
02/01/2012<br />
01/31/2013<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treat/Children 1 w/Telehealth DHS 40.11(2)(a)<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment for Children 1 DHS 40.11(2)(a)<br />
2160<br />
NORTHWEST JOURNEY - GREEN BAY<br />
JENNIFER SOVEY-FAHEY<br />
123 S. VAN BUREN STREET<br />
GREEN BAY, WI 54301<br />
County: Brown<br />
nwjgreenbay@nwcgc.com<br />
Phone: (920) 437-4024<br />
Fax: (920) 437-4343<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 />
NO BRANCH LOCATIONS<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
11/01/1999<br />
11/01/2011<br />
10/31/2013<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treat/Children 1 w/Telehealth DHS 40.11(2)(a)<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment for Children 1 DHS 40.11(2)(a)<br />
2660<br />
NORTHWEST JOURNEY - MENOMONIE<br />
JUSTINE PETERSON<br />
402 TECHNOLOGY DRIVE EAST<br />
MENOMONIE, WI 54751<br />
County: Dunn<br />
just<strong>in</strong>ep@nwcgc.com<br />
Phone: (715) 235-4245<br />
Fax: (715) 235-4421<br />
Surveyor: Polly Wong<br />
Services<br />
NO BRANCH LOCATIONS<br />
02/01/2012 01/31/2013<br />
02/01/2012 01/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
03/01/2006<br />
03/01/2012<br />
02/28/2014<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treat/Children 1 w/Telehealth DHS 40.11(2)(a)<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment for Children 1 DHS 40.11(2)(a)<br />
NO BRANCH LOCATIONS<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
03/01/2012 02/28/2014<br />
03/01/2012 02/28/2014
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