Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
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 265 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1810<br />
ROGERS MEMORIAL HOSPITAL<br />
KATHY LOTZ<br />
34700 VALLEY ROAD<br />
OCONOMOWOC, WI 53066<br />
County: Waukesha<br />
No Email Address Provided<br />
Phone: (800) 767-4411<br />
Fax: (262) 646-3158<br />
Surveyor: Mark Isaacs<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 />
08/01/1988<br />
11/01/2011<br />
10/31/2013<br />
CSAS-Day Treatment DHS 75.12<br />
CSAS-Day Treatment with Telehealth DHS 75.12<br />
CSAS-Medically Managed Inpatient Detox DHS 75.06<br />
CSAS-Medically Managed Inpatient Treatment DHS 75.10<br />
CSAS-Medically Monitored Treatment DHS 75.11<br />
CSAS-Outpatient Treatment DHS 75.13<br />
CSAS-Outpatient Treatment with Telehealth DHS 75.13<br />
<strong>Mental</strong> <strong>Health</strong>-Adolescent Inpatient DHS 61.79<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treat/Chldren 3 w/Telehealth DHS 40.11(2)(c)<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment DHS 61.75<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment for Children 3 DHS 40.11(2)(c)<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment with Telehealth DHS 61.75<br />
<strong>Mental</strong> <strong>Health</strong>-Inpatient DHS 61.71<br />
2691<br />
RUSK COUNTY HEALTH & HUMAN<br />
SERVICES/ACCESS, INC.<br />
TED EAST<br />
311 E MINER AVENUE<br />
LADYSMITH, WI 54848<br />
County: Rusk<br />
teast@ruskcounty.wi.us<br />
Phone: (715) 532-2247<br />
Fax: (715) 532-2126<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 />
05/16/2006<br />
05/01/2012<br />
04/30/2014<br />
<strong>Mental</strong> <strong>Health</strong>-Emergency Service 3 DHS 34.3<br />
NO BRANCH LOCATIONS<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
11/01/2011 10/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
05/01/2012 04/30/2014
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