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 330 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1993 WISCONSIN COMMUNITY SERVICES-COMMUNITY SUPPORT PROGRAM JANET WIMMER 3734 W. WISCONSIN AVENUE MILWAUKEE, WI 53208 County: Milwaukee jwimmer@wiscs.org Phone: (414) 344-6111 Fax: (414) 334-2191 Surveyor: Demetrius Anderson Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 11/01/1995 06/01/2011 10/31/2012 Mental Health-Community Support Program DHS 63 1996 WISCONSIN EARLY AUTISM PROJECT, INC. KIM SCHUTT-CHARDON 1210 FOURIER DRIVE SUITE 100 MADISON, WI 53717 County: Dane kim.schutt-chardon@wiautism.com Phone: (608) 662-9327 Fax: (608) 662-9041 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 05/01/1997 06/27/2011 04/30/2013 Mental Health Outpatient Clinic DHS 35 2440 WISCONSIN EARLY AUTISM PROJECT, INC. KIM SCHUTT-CHARDON 2125 HEIGHTS DRIVE SUITE 2F EAU CLAIRE, WI 54701 County: Eau Claire kim.schutt-chardon@wiautism.com Phone: (715) 832-2233 Fax: (715) 833-1666 Surveyor: Polly Wong Services NO BRANCH LOCATIONS 06/01/2011 10/31/2012 Administrative Code Chapter Service Begin/End Dates 05/12/2003 06/01/2011 05/31/2013 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 06/27/2011 04/30/2013 Administrative Code Chapter Service Begin/End Dates 06/01/2011 05/31/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 331 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2441 WISCONSIN EARLY AUTISM PROJECT, INC. GLEN O SALLOWS 1113 RIDERS CLUB ROAD ONALASKA, WI 54650 County: La Crosse kim.schutt-chardon@wiautism.com Phone: (608) 781-6500 Fax: (608) 783-7642 Surveyor: Polly Wong Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 05/13/2003 06/01/2009 05/31/2011 Mental Health Outpatient Clinic DHS 35 Mental Health-Outpatient DHS 61.91 2460 WISCONSIN EARLY AUTISM PROJECT, INC. KIM SCHUTT-CHARDON 1141 W. MAIN AVE #201 DE PERE, WI 54115 County: Brown kim.schutt-chardon@wiautism.com Phone: (608) 662-9041 Fax: (608) 662-9041 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 04/01/2003 04/01/2011 03/31/2013 Mental Health Outpatient Clinic DHS 35 2461 WISCONSIN EARLY AUTISM PROJECT, INC KIM SCHUTT-CHARDON 150 N. SUNNYSLOPE RD SUITE 100 BROOKFIELD, WI 53005 County: Waukesha kim.schutt-chardon@wiautism.com Phone: (608) 662-9327 Fax: (608) 662-9041 Surveyor: Mark Isaacs Services NO BRANCH LOCATIONS 06/01/2011 05/31/2011 06/01/2009 05/31/2011 Administrative Code Chapter Service Begin/End Dates 05/20/2003 06/01/2012 05/31/2014 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 04/01/2011 03/31/2013 Administrative Code Chapter Service Begin/End Dates 06/01/2012 05/31/2014
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