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 26 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2736 AURORA BEHAVIORAL HEALTH CENTER SARA HEBEL 1881 CHICAGO STREET DE PERE, WI 54115 County: Brown sara.hebel@aurora.org Phone: (920) 403-8061 Fax: (920) 403-8209 Surveyor: Frank Bellaire Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 06/08/2007 07/01/2012 06/30/2014 Mental Health Outpatient Clinic DHS 35 1336 AURORA FAMILY SERVICE, INC. ROBERT MARRS 3200 W. HIGHLAND BOULEVARD MILWAUKEE, WI 53208 County: Milwaukee robert.marrs@aurora.org Phone: (414) 345-4940 Fax: (414) 342-5326 Surveyor: Demetrius Anderson 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 05/01/1977 08/01/2012 07/31/2014 Mental Health Outpatient Clinic DHS 35 1867 AURORA HEALTH CARE METRO, INC. DBA AURORA ST. LUKE'S SOUTH SHORE NANCYANN MARIGOMEN 5900 S. LAKE DRIVE CUDAHY, WI 53110 County: Milwaukee No Email Address Provided Phone: (414) 489-4125 Fax: (414) 489-4056 Surveyor: Demetrius Anderson Services NO BRANCH LOCATIONS 07/01/2012 06/30/2014 Administrative Code Chapter Service Begin/End Dates 11/01/1989 10/01/2010 09/30/2012 CSAS-Medically Managed Inpatient Detox DHS 75.06 Mental Health-Day Treatment DHS 61.75 Mental Health-Inpatient DHS 61.71 NO BRANCH LOCATIONS 08/01/2012 07/31/2014 Administrative Code Chapter Service Begin/End Dates 10/01/2010 09/30/2012 01/01/2012 09/30/2012 10/01/2010 09/30/2012
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 27 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2517 AURORA MEDICAL GROUP BEHAVIORAL HEALTH SERVICES - LAKE GENEVA KATE CONNELLY 146 E GENEVA SQUARE LAKE GENEVA, WI 53147 County: Walworth kate.connelly@aurora.org Phone: (414) 454-6506 Fax: (414) 454-6450 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 02/01/2004 02/01/2011 01/31/2013 Mental Health Outpatient Clinic DHS 35 1089 AURORA MEDICAL GROUP BEHAVIORAL HEALTH SERVICES KATE CONNELLY 190 GARDNER AVENUE, #3 BURLINGTON, WI 53105 County: Racine kateconnelly@aurora.org Phone: (262) 763-7766 Fax: (262) 763-9326 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 AURORA HEALTH CENTER - DELAVAN Tier 1 1550 HOBBS DRIVE 02/01/2011 DELAVAN, WI 53115 01/31/2013 AURORA HEALTH CENTER - ELKHORN Tier 1 205 E COMMERCE COURT 02/01/2011 ELKHORN, WI 53121 01/31/2013 Administrative Code Chapter Service Begin/End Dates 10/01/1983 02/01/2011 01/31/2013 Mental Health Outpatient Clinic DHS 35 2218 AURORA MEDICAL GROUP BEHAVIORAL HEALTH SERVICES KATE CONNELLY 12225 - 71ST STREET KENOSHA, WI 53142 County: Kenosha No Email Address Provided Phone: (262) 948-4870 Fax: (262) 948-4871 Surveyor: Mark Isaacs Services AURORA MED GROUP BEHAV HLTH-WATERFORD 818 FORREST WATERFORD, WI 53185 02/01/2011 01/31/2013 Tier 1 02/01/2011 01/31/2013 Administrative Code Chapter Service Begin/End Dates 09/24/1998 10/01/2011 09/30/2013 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 02/01/2011 01/31/2013 Administrative Code Chapter Service Begin/End Dates 10/01/2011 09/30/2013
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