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 302 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2915 TRANSITIONS BEHAVIORAL HEALTH, LLC JESSICA BECKETT 317 DE WITT AVENUE PORTAGE, WI 53901 County: Columbia transitions.office@frontier.com Phone: (608) 566-3813 Fax: (608) 745-1757 Surveyor: William Goehring Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/01/2010 07/01/2011 06/30/2013 Mental Health Outpatient Clinic DHS 35 2642 TRANSITIONS CENTER, LLC RICHARD MARTIN 22 N PELHAM STREET RHINELANDER, WI 54501 County: Oneida transitionscenter@frontiernet.net Phone: (715) 365-6696 Fax: (715) 365-6768 Surveyor: Bradley Jahr 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 02/01/2006 02/01/2011 01/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 2564 TRILLIUM CARE GROUP, LLC TERESA C. ORTIZ 500 ELM GROVE ROAD, #100 ELM GROVE, WI 53122 County: Waukesha Tortiz@trilliumcare.com Phone: (262) 782-2090 Fax: (262) 782-2092 Surveyor: Mark Isaacs Services NO BRANCH LOCATIONS 07/01/2011 06/30/2013 Administrative Code Chapter Service Begin/End Dates 01/01/2005 01/01/2012 12/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 02/01/2011 01/31/2013 02/01/2011 01/31/2013 TRILLIUM CARE GROUP LLC Tier 1 4811 S 76TH ST, #309 01/01/2012 GREENFIELD, WI 53220 12/31/2013 Administrative Code Chapter Service Begin/End Dates 01/01/2012 12/31/2013 01/01/2012 12/31/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 303 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1936 TRINITEAM, INC. ROBERT PEITZMAN 202 GRAHAM AVENUE EAU CLAIRE, WI 54701 County: Eau Claire rob@triniteam.org Phone: (715) 858-9801 Fax: (715) 836-8104 Surveyor: Polly Wong Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 03/01/1989 04/01/2011 03/31/2013 CSAS-Outpatient Treatment DHS 75.13 1938 TURCOTT MEDICAL AND PSYCHIATRIC ASSOCIATES RICHARD TURCOTT 2600 N. MAYFAIR ROAD, #785 WAUWATOSA, WI 53226 County: Milwaukee turcottmedical@yahoo.com Phone: (414) 258-5704 Fax: (414) 258-8406 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 02/01/1978 04/01/2011 03/31/2013 Mental Health Outpatient Clinic DHS 35 1941 UNIFIED COMMUNITY SERVICES COMMUNITY SUPPORT PROGRAM NEAL BLACKBURN, PHD 200 W. ALONA LANE LANCASTER, WI 53813 County: Grant cknapp@unifiedservices.org Phone: (608) 723-6357 Fax: (608) 723-4417 Surveyor: Cynthia Lindgren Services NO BRANCH LOCATIONS 04/01/2011 03/31/2013 Administrative Code Chapter Service Begin/End Dates 07/01/1994 10/01/2010 09/30/2012 Mental Health-Community Support Program DHS 63 NO BRANCH LOCATIONS 04/01/2011 03/31/2013 Administrative Code Chapter Service Begin/End Dates 10/01/2010 09/30/2012
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Mental Health and Substance Abuse Programs in alphabetical

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