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 262 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1807 ROCK COUNTY HUMAN SERVICES DEPARTMENT JANESVILLE COUNSELING CENTER KENT HUBBARD 113 S FRANKLIN STREET JANESVILLE, WI 53548 County: Rock RCHSD@co.rock.wi.us Phone: (608) 757-5850 Fax: (608) 758-5858 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 10/01/1975 09/01/2011 08/31/2012 Mental Health Outpatient Clinic DHS 35 2799 ROCK VALLEY COMMUNITY PROGRAMS, INC. DBA BELOIT YOUTH PLACE EMMA HARRELL 416 COLLEGE STREET, #A BELOIT, WI 53511 County: Rock aeggers@rvcp.org Phone: (608) 365-0810 Fax: (608) 365-0711 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 08/18/2008 08/01/2011 07/31/2013 CSAS-Outpatient Treatment DHS 75.13 1809 ROCK VALLEY COMMUNITY PROGRAMS, INC. EMMA HARRELL 203 W. SUNNY LANE ROAD JANESVILLE, WI 53546 County: Rock eharrell@rvcp.org Phone: (608) 741-4500 Fax: (608) 741-4502 Surveyor: William Rohner Services NO BRANCH LOCATIONS 09/01/2011 08/31/2012 Administrative Code Chapter Service Begin/End Dates 03/01/1990 03/01/2012 02/28/2014 CSAS-Outpatient Treatment DHS 75.13 NO BRANCH LOCATIONS 08/01/2011 07/31/2013 Administrative Code Chapter Service Begin/End Dates 03/01/2012 02/28/2014
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 263 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2532 ROGERS MEMORIAL HOSPITAL - CHILD & ADOLESCENT DAY TREATMENT KRISTINE KIM 4600 SCHROEDER DRIVE BROWN DEER, WI 53223 County: Milwaukee KKim@rogershospital.org Phone: (414) 355-9000 Fax: (414) 355-9665 Surveyor: William Goehring Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/13/2004 07/01/2011 06/30/2013 Mental Health Outpatient Clinic DHS 35 Mental Health-Day Treatment for Children 2 DHS 40.11(2)(b) 2070 ROGERS MEMORIAL HOSPITAL - HERRINGTON RECOVERY CENTER CINDY SUSZEK 34700 VALLEY ROAD OCONOMOWOC, WI 53066 County: Waukesha csuszek@rogershospital.org Phone: (262) 646-1616 Fax: (262) 646-3158 Surveyor: Mark Isaacs 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 06/01/1998 06/01/2011 05/31/2013 CSAS-Medically Monitored Treatment DHS 75.11 CSAS-Transitional Residential DHS 75.14 2920 ROGERS MEMORIAL HOSPITAL - MADISON PARTIAL HOSPITALIZATION PROGRAM DAVID GEBAUER 406 SCIENCE DRIVE, #110 MADISON, WI 53711 County: Dane DGebauer@rogershospital.org Phone: (608) 238-4411 Fax: (608) 238-4412 Surveyor: William Rohner Services NO BRANCH LOCATIONS 07/01/2011 06/30/2013 07/01/2011 06/30/2013 Administrative Code Chapter Service Begin/End Dates 10/13/2010 11/01/2011 10/31/2013 Mental Health-Day Treat/Children 2 w/Telehealth DHS 40.11(2)(b) Mental Health-Day Treatment DHS 61.75 Mental Health-Day Treatment for Children 2 DHS 40.11(2)(b) Mental Health-Day Treatment with Telehealth DHS 61.75 NO BRANCH LOCATIONS 06/01/2011 05/31/2013 06/01/2011 05/31/2013 Administrative Code Chapter Service Begin/End Dates 11/01/2011 10/31/2013 11/01/2011 10/31/2013 11/01/2011 10/31/2013 11/01/2011 10/31/2013
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Mental Health and Substance Abuse Programs in alphabetical

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