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 276 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2679 SONAS BEHAVIORAL HEALTH, LLC DELORES KLUPPEL VETTER 6402 ODANA MADISON, WI 53719 County: Dane dkvetter@charter.net Phone: (608) 204-6076 Fax: (608) 204-9568 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/26/2006 09/15/2009 06/30/2011 Mental Health Outpatient Clinic DHS 35 1841 SOUTH STREET CLINIC ANNE A WESTON, PHD 416 SOUTH STREET OCONOMOWOC, WI 53066 County: Waukesha s_clinic@hotmail.com Phone: (262) 567-7673 Fax: (262) 567-3097 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 06/01/1984 06/01/2012 05/31/2014 Mental Health Outpatient Clinic DHS 35 2197 SOUTHWEST HEALTH CENTER SENIOR BEHAVIORAL SCIENCE JOYCE GRAVES 1185 NORTH ELM STREET PLATTEVILLE, WI 53818 County: Grant GravesJ@southwesthealth.org Phone: (608) 348-3656 Fax: (608) 342-3025 Surveyor: Cynthia Lindgren Services NO BRANCH LOCATIONS 09/15/2009 06/30/2011 Administrative Code Chapter Service Begin/End Dates 03/01/2000 03/01/2012 02/28/2013 Mental Health Outpatient Clinic DHS 35 Mental Health-Inpatient DHS 61.71 NO BRANCH LOCATIONS 06/01/2012 05/31/2014 Administrative Code Chapter Service Begin/End Dates 03/01/2012 02/28/2013 03/01/2012 02/28/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 277 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2907 SPADE'S COUNSELING AGENCY DIANE E SPADE 908 - SECOND STREET MENOMINEE, MI 49858 County/State: Menominee, MI dianespade@spadescounseling.com Phone: (906) 864-9830 Fax: (906) 864-9831 Surveyor: Frank Bellaire Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/07/2010 08/01/2012 07/31/2014 Mental Health Outpatient Clinic DHS 35 2355 SPANISH SPEAKING COUNSELING SERVICES JAVIER CADENA 1118 W VETERANS STREET TOMAH, WI 54660 County: Monroe blkwlf48@yahoo.com Phone: (608) 547-1209 Fax: (608) 374-5567 Surveyor: Polly Wong Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates SPADE'S COUNSELING AGENCY Tier 1 1651 LUDINGTON STREET, #B 08/01/2012 MARINETTE, WI 54143 07/31/2014 Administrative Code Chapter Service Begin/End Dates 08/10/2012 08/01/2012 07/31/2014 CSAS-Outpatient Treatment DHS 75.13 1847 ST AGNES HOSPITAL BEHAVIORAL HEALTH SERVICES JAMES SALASEK PHD 430 E. DIVISION STREET FOND DU LAC, WI 54935 County: Fond Du Lac salesekJ@agnesian.com Phone: (920) 926-4200 Fax: (920) 926-8933 Surveyor: William Goehring Services NO BRANCH LOCATIONS 08/01/2012 07/31/2014 Administrative Code Chapter Service Begin/End Dates 05/01/1980 01/01/2012 12/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Day Treatment DHS 75.12 CSAS-Medically Managed Inpatient Detox DHS 75.06 CSAS-Medically Managed Inpatient Treatment DHS 75.10 CSAS-Medically Monitored Treatment DHS 75.11 CSAS-Outpatient Treatment DHS 75.13 CSAS-Transitional Residential DHS 75.14 Mental Health-Day Treatment DHS 61.75 Mental Health-Inpatient DHS 61.71 08/01/2012 07/31/2014 ST AGNES HOSPITAL BEHAV HLTH Tier 2 790 EASTGATE DRIVE 01/01/2012 RIPON, WI 54971 12/31/2013 ST AGNES HOSPITAL BEHAVIORAL HEALTH SVS Tier 1 620 W BROWN STREET 01/01/2012 WAUPUN, WI 53963 12/31/2013 Administrative Code Chapter Service Begin/End Dates 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013 01/01/2012 12/31/2013
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