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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 237 of 335<br />

Certification Number/<br />

Certified Provider's Ma<strong>in</strong> Site/<br />

Email/Telephone<br />

2715<br />

PEACEFUL SOLUTIONS COUNSELING<br />

LEE SHIPWAY<br />

1720 MERRILL AVENUE, #300<br />

WAUSAU, WI 54401<br />

County: Marathon<br />

lee@peacefulsolutions.org<br />

Phone: (715) 675-3458<br />

Fax: (715) 675-7238<br />

Surveyor: Bradley Jahr<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 />

03/01/2007<br />

03/01/2012<br />

02/28/2014<br />

<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />

2923<br />

PENFIELD CHILDREN'S CENTER<br />

HEATHER ROTOLO<br />

833 N 26TH STREET<br />

MILWAUKEE, WI 53233<br />

County: Milwaukee<br />

heatherrotolo@penfieldchildren.org<br />

Phone: (414) 345-6337<br />

Fax: (414) 344-7739<br />

Surveyor: William Goehr<strong>in</strong>g<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 />

10/01/2010<br />

10/01/2011<br />

09/30/2013<br />

<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />

1733<br />

PERFORMANCE ENHANCEMENT HEALTH<br />

SERVICES, SC<br />

JODI PETERNEL<br />

8800 W 102ND STREET #103<br />

FRANKLIN, WI 53132<br />

County: Milwaukee<br />

pepetjodi@hotmail.com<br />

Phone: (414) 858-1014<br />

Fax: (414) 858-1017<br />

Surveyor: Demetrius Anderson<br />

Services<br />

NO BRANCH LOCATIONS<br />

03/01/2012 02/28/2014<br />

Adm<strong>in</strong>istrative<br />

Code Chapter Service Beg<strong>in</strong>/End Dates<br />

03/11/1991<br />

02/01/2012<br />

01/31/2014<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 />

PERFORMANCE ENHANCEMENT<br />

HEALTH SERVICES SC<br />

7418 TICHIGAN ROAD<br />

WATERFORD, WI 53185<br />

10/01/2011 09/30/2013<br />

Tier 1<br />

02/01/2012<br />

01/31/2014<br />

Adm<strong>in</strong>istrative<br />

Code Chapter Service Beg<strong>in</strong>/End Dates<br />

02/01/2012 01/31/2014<br />

02/01/2012 01/31/2014

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