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 228 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2675 OCEANHAWK COUNSELING ALTERNATIVES, LLC JEAN DAUTE 135 W MAIN STREET, #207A STOUGHTON, WI 53589 County: Dane counseling@oceanhawk.net Phone: (608) 873-7838 Fax: (608) 541-8351 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/17/2006 07/01/2011 06/30/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 1713 O'CONNELL, LONG AND ASSOCIATES COUNSELING SERVICES TRUMAN G LONG 1421 B RACINE STREET DELAVAN, WI 53115 County: Walworth No Email Address Provided Phone: (262) 728-7844 Fax: (262) 642-5146 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 07/01/1988 06/01/2008 10/31/2009 Mental Health-Outpatient DHS 61.91 2729 OCONOMOWOC COMMUNITY SERVICES LLC DEBBIE FRISK 36100 GENESEE LAKE ROAD OCONOMOWOC, WI 53066 County: Waukesha dfrisk@odtc-wi.com Phone: (262) 569-5515 Fax: (262) 569-9962 Surveyor: Mark Isaacs Services NO BRANCH LOCATIONS 07/01/2011 06/30/2013 07/01/2011 06/30/2013 Administrative Code Chapter Service Begin/End Dates 05/01/2007 05/01/2007 04/30/2008 Mental Health-Outpatient DHS 61.91 NO BRANCH LOCATIONS 06/01/2008 10/31/2009 Administrative Code Chapter Service Begin/End Dates 05/01/2007 04/30/2008
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 229 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1719 OCONTO COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES BRUCE RETZLAFF 501 PARK AVENUE OCONTO, WI 54153 County: Oconto bruce.retzlaff@co.oconto.wi.us Phone: (920) 834-7000 Fax: (920) 834-6889 Surveyor: Frank Bellaire Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 04/01/1979 09/01/2012 08/31/2014 Mental Health Outpatient Clinic DHS 35 CSAS-Emergency Outpatient DHS 75.05 CSAS-Outpatient Treatment DHS 75.13 CSAS-Prevention DHS 75.04 Mental Health-Emergency Service 3 DHS 34.3 1720 OMNE CLINIC, INC. MARK JUERGENS 2005 HIGHLAND AVENUE EAU CLAIRE, WI 54701 County: Eau Claire contact@omneclinic.com Phone: (715) 832-5454 Fax: (715) 832-2991 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 NEW VIEW INDUSTRIES Tier 1 164 W PARK STREET 09/01/2012 GILLETT, WI 54124 08/31/2014 Administrative Code Chapter Service Begin/End Dates 10/01/1987 10/01/2010 09/30/2012 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 2413 OMNI ENRICHMENT, INC. BARBARA TRIPP 3020 W. VLIET STREET MILWAUKEE, WI 53208 County: Milwaukee omnienrichment8814@att.net Phone: (414) 312-8910 Fax: (414) 455-3292 Surveyor: Demetrius Anderson Services 09/01/2012 08/31/2014 09/01/2012 08/31/2014 09/01/2012 08/31/2014 09/01/2012 08/31/2014 09/01/2012 08/31/2014 OMNE CLINIC INC Tier 2 233 E LASALLE STREET 10/01/2010 BARRON, WI 54812 09/30/2012 Administrative Code Chapter Service Begin/End Dates 02/01/2003 04/01/2012 03/31/2014 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 NO BRANCH LOCATIONS 10/01/2010 09/30/2012 10/01/2010 09/30/2012 Administrative Code Chapter Service Begin/End Dates 04/01/2012 03/31/2014 04/01/2012 03/31/2014
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