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 68 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1227 COMMUNITY MENTAL HEALTH SERVICES, INC. BEVERLY SCHOENENBERGER 1831 N. STEVENS STREET RHINELANDER, WI 54501 County: Oneida No Email Address Provided Phone: (715) 365-7000 Fax: (715) 365-7029 Surveyor: Bradley Jahr Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 10/01/1986 04/01/2011 03/31/2013 Mental Health Outpatient Clinic DHS 35 1228 COMMUNITY PSYCHOLOGICAL SERVICES OF WAUPUN, LLC ROBERT DEYOUNG 1208 S. WATERTOWN STREET WAUPUN, WI 53963 County: Dodge deyourn@charter.net Phone: (920) 324-4358 Fax: (920) 324-4737 Surveyor: William Goehring Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates COMMUNITY MENTAL HEALTH SERVICES INC 603 B EAST WALL STREET EAGLE RIVER, WI 54521 COMMUNITY MENTAL HEALTH SERVICES, INC 301 S LAKE STREET CRANDON, WI 54520 Tier 1 04/01/2011 03/31/2013 Tier 1 04/01/2011 03/31/2013 Administrative Code Chapter Service Begin/End Dates 06/01/1983 03/01/2012 02/28/2014 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 2149 COMMUNITY SERVICES ASSOCIATES, SC DBA PAUQUETTE CTR FOR PSYCHOLOGICAL SVS DOUGLAS C VARVIL-WELD 2901 HUNTERS TRAIL PORTAGE, WI 53901 County: Columbia clinic@pauquette.com, dcvweld@pauquette.com Phone: (608) 742-5518 Fax: (608) 742-4087 Surveyor: William Goehring Services NO BRANCH LOCATIONS 04/01/2011 03/31/2013 Administrative Code Chapter Service Begin/End Dates 10/08/1999 07/01/2011 06/30/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Emergency Outpatient DHS 75.05 CSAS-Outpatient Treatment DHS 75.13 COMMUNITY SERV ASSOC DBA PAUQUETTE CTR 23295 US HIGHWAY 14 WEST RICHLAND CENTER, WI 53581 COMMUNITY SERV ASSOC DBA PAUQUETTE CTR 1339 PARK AVENUE COLUMBUS, WI 53925 03/01/2012 02/28/2014 03/01/2012 02/28/2014 Tier 2 07/01/2011 06/30/2013 Tier 2 07/01/2011 06/30/2013 Administrative Code Chapter Service Begin/End Dates 07/01/2011 06/30/2013 07/01/2011 06/30/2013 07/01/2011 06/30/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 69 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1424 COMMUNITY SERVICES ASSOCIATES, SC DOUGLAS VARVIL-WELD 23295 U.S. HIGHWAY 14, WEST RICHLAND CENTER, WI 53581 County: Richland clinic@pauquette.com Phone: (608) 647-4705 Fax: (608) 647-8979 Surveyor: Cynthia Lindgren Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 07/01/1997 02/01/2008 01/31/2010 CSAS-Outpatient Treatment DHS 75.13 Mental Health-Outpatient DHS 61.91 1231 COMMUNITY SUPPORT CENTER OF PRICE COUNTY PAM OLSON 548 N. LAKE AVENUE PHILLIPS, WI 54555 County: Price commsupp@pctcnet.net Phone: (715) 339-6449 Fax: (715) 339-6450 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 04/01/1998 01/01/2012 12/31/2013 Mental Health-Community Support Program DHS 63 2157 COMMUNITY SUPPORT CENTER OF RUSK COUNTY PAMELA OLSON 219 WEST 2ND STREET, N LADYSMITH, WI 54848 County: Rusk commsupp@pctcnet.net Phone: (715) 339-6449 Fax: (715) 339-6450 Surveyor: Bradley Jahr Services NO BRANCH LOCATIONS 02/01/2008 01/31/2010 02/01/2008 01/31/2010 Administrative Code Chapter Service Begin/End Dates 10/27/1999 10/01/2010 09/30/2012 Mental Health-Community Support Program DHS 63 NO BRANCH LOCATIONS 01/01/2012 12/31/2013 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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