29.12.2012 Views

Mental Health and Substance Abuse Programs in alphabetical

Mental Health and Substance Abuse Programs in alphabetical

Mental Health and Substance Abuse Programs in alphabetical

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

DEPARTMENT OF HEALTH SERVICES<br />

Division of Quality Assurance<br />

Pr<strong>in</strong>t Date: 08/28/2012<br />

Page 259 of 335<br />

Certification Number/<br />

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

Email/Telephone<br />

2264<br />

RIVERSIDE PSYCHIATRIC GROUP, SC<br />

KAREN SCHULTZ<br />

1325 ANGELS PATH<br />

DE PERE, WI 54115<br />

County: Brown<br />

Karens@Riversidepsych.com<br />

Phone: (920) 338-2855<br />

Fax: (920) 338-9270<br />

Surveyor: Frank Bellaire<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 />

12/01/2000<br />

01/01/2011<br />

12/31/2012<br />

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

CSAS-Outpatient Treatment DHS 75.13<br />

1802<br />

RIVERVIEW HOSPITAL ASSOCIATION<br />

COLLEEN KANE<br />

410 DEWEY STREET<br />

WISCONSIN RAPIDS, WI 54495<br />

County: Wood<br />

No Email Address Provided<br />

Phone: (715) 423-6060<br />

Fax: (715) 421-7512<br />

Surveyor: Bradley Jahr<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 />

07/01/1986<br />

07/01/2012<br />

06/30/2014<br />

CSAS-Medically Managed Inpatient Detox DHS 75.06<br />

2622<br />

RIVERVIEW PSYCHOTHERAPY<br />

LAURA PAGEL<br />

216 N WATER STREET, #2<br />

MILWAUKEE, WI 53202<br />

County: Milwaukee<br />

LLPisme@sbcglobal.net<br />

Phone: (414) 223-4000<br />

Fax: (414) 223-2660<br />

Surveyor: Demetrius Anderson<br />

Services<br />

NO BRANCH LOCATIONS<br />

01/01/2011 12/31/2012<br />

01/01/2011 12/31/2012<br />

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

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

11/01/2005<br />

11/01/2008<br />

10/31/2010<br />

<strong>Mental</strong> <strong>Health</strong>-Outpatient DHS 61.91<br />

NO BRANCH LOCATIONS<br />

07/01/2012 06/30/2014<br />

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

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

11/01/2008 10/31/2010

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!