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 32 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1085<br />
BEACON HOUSE<br />
MARY GERLACH<br />
166 SOUTH PARK AVENUE<br />
FOND DU LAC, WI 54936<br />
County: Fond Du Lac<br />
fwrbeacon@tds.net<br />
Phone: (920) 923-3999<br />
Fax: (920) 923-3240<br />
Surveyor: William Goehr<strong>in</strong>g<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 />
05/28/1993<br />
06/01/2012<br />
05/31/2014<br />
CSAS-Outpatient Treatment DHS 75.13<br />
CSAS-Transitional Residential DHS 75.14<br />
1087<br />
BEHAVIORAL CONSULTANTS, INC.<br />
SUSAN ZANOLA<br />
1428 N. FARWELL AVENUE, #210<br />
MILWAUKEE, WI 53202<br />
County: Milwaukee<br />
bci@core.com<br />
Phone: (414) 271-5577<br />
Fax: (414) 271-6667<br />
Surveyor: William Goehr<strong>in</strong>g<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 />
05/01/1984<br />
12/01/2008<br />
11/30/2010<br />
<strong>Mental</strong> <strong>Health</strong>-Outpatient DHS 61.91<br />
2154<br />
BEHAVIORAL HEALTH SERVICES OF MEMORIAL<br />
MEDICAL CENTER<br />
TOM MCMULLIN<br />
1635 MAPLE LANE<br />
ASHLAND, WI 54806<br />
County: Ashl<strong>and</strong><br />
tmcmull<strong>in</strong>@ashl<strong>and</strong>mmc.com<br />
Phone: (715) 685-5400<br />
Fax: (715) 685-5102<br />
Surveyor: Bradley Jahr<br />
Services<br />
NO BRANCH LOCATIONS<br />
06/01/2012 05/31/2014<br />
06/01/2012 05/31/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
10/01/1999<br />
10/01/2011<br />
09/30/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Day Treatment DHS 75.12<br />
CSAS-Outpatient Treatment DHS 75.13<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment DHS 61.75<br />
<strong>Mental</strong> <strong>Health</strong>-Emergency Service 2 DHS 34.2<br />
<strong>Mental</strong> <strong>Health</strong>-Inpatient DHS 61.71<br />
12/01/2008 11/30/2010<br />
ASHLAND COUNTY JAIL Tier 1<br />
221 - 7TH ST, EAST<br />
10/01/2011<br />
ASHLAND, WI 54806<br />
09/30/2013<br />
ASHLAND SCHOOL DISTRICT - MIDDLE<br />
SCHOOL<br />
Tier 1<br />
203 - 11TH STREET EAST<br />
10/01/2011<br />
ASHLAND, WI 54806<br />
09/30/2013<br />
BAYFIELD COUNTY JAIL Tier 1<br />
117 E 6TH ST<br />
10/01/2011<br />
WASHBURN, WI 54891<br />
09/30/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
10/01/2011 09/30/2013<br />
10/01/2011 09/30/2013<br />
10/01/2011 09/30/2013<br />
10/01/2011 09/30/2013<br />
10/01/2011 09/30/2013<br />
10/01/2011 09/30/2013
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