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 38 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2442 BELLIN PSYCHIATRIC CENTER-BELLEVUE STEVE DUSCHER 3263 EATON ROAD GREEN BAY, WI 54311 County: Brown sldusc@bellin.org Phone: (920) 338-6830 Fax: (920) 338-6819 Surveyor: Frank Bellaire Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 10/10/2002 11/01/2010 10/31/2012 Mental Health Outpatient Clinic DHS 35 2233 BELLIN PSYCHIATRIC CENTER-PESHTIGO STEVE DUSCHER 441 FRENCH STREET PESHTIGO, WI 54157 County: Marinette sldusc@bellin.org Phone: (920) 431-5687 Fax: (920) 431-0333 Surveyor: Frank Bellaire Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates BELLIN PSYCHIATRIC CENTER-MANITOWOC 3415 CUSTER STREET, #D MANITOWOC, WI 54220 Tier 1 11/01/2010 10/31/2012 Administrative Code Chapter Service Begin/End Dates 06/23/2000 04/01/2012 03/31/2014 Mental Health Outpatient Clinic DHS 35 2284 BELLIN PSYCHIATRIC CENTER-W DEPERE STEVE DUSCHER 1800 LAWRENCE DRIVE DE PERE, WI 54115 County: Brown sldusc@bellin.org Phone: (920) 431-5687 Fax: (920) 431-0333 Surveyor: Frank Bellaire Services NO BRANCH LOCATIONS 11/01/2010 10/31/2012 Administrative Code Chapter Service Begin/End Dates 01/26/2001 04/01/2012 03/31/2014 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 04/01/2012 03/31/2014 Administrative Code Chapter Service Begin/End Dates 04/01/2012 03/31/2014
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 39 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2198 BELOIT AREA COMMUNITY HEALTH CENTER LYNN LARSEN 74 ECLIPSE CENTER BELOIT, WI 53511 County: Rock llarsen@bachc.com Phone: (608) 299-3309 Fax: (608) 361-0312 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 02/01/2000 02/01/2011 01/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 1099 BELOIT INNER CITY COUNCIL, INC./DIVISION OF TELLURIAN UCAN BARBARA RUCKER 74 ECLIPSE CENTER BELOIT, WI 53511 County: Rock Brucker@tellurian.org Phone: (608) 365-6600 Fax: (608) 365-7787 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 HEAD START Tier 1 221 HENRY AVENUE 02/01/2011 BELOIT, WI 53511 01/31/2013 RACINE AREA COMMUNITY HEATLH CENTER Tier 2 2405 NORTHWESTERN AVENUE 02/01/2011 RACINE, WI 53404 01/31/2013 Administrative Code Chapter Service Begin/End Dates 05/01/1991 05/01/2009 04/30/2010 CSAS-Outpatient Treatment DHS 75.13 1100 BELOIT MEMORIAL HOSPITAL-COUNSELING CARE CENTER GREG AMMON 1969 W. HART ROAD BELOIT, WI 53511 County: Rock gammon@beloitmemorialhospital.org Phone: (608) 364-5686 Fax: (608) 363-5756 Surveyor: William Rohner Services NO BRANCH LOCATIONS 02/01/2011 01/31/2013 02/01/2011 01/31/2013 Administrative Code Chapter Service Begin/End Dates 07/01/1985 12/01/2011 11/30/2012 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 05/01/2009 04/30/2010 JANESVILLE OCCUPATIONAL HEALTH Tier 1 1409B CRESTON PARK DRIVE 12/01/2011 JANESVILLE, WI 53545 11/30/2012 Administrative Code Chapter Service Begin/End Dates 12/01/2011 11/30/2012 12/01/2011 11/30/2012
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Mental Health and Substance Abuse Programs in alphabetical

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