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 87 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1282<br />
DODGE COUNTY HUMAN SERVICES AND HEALTH<br />
DEPARTMENT<br />
ALYSSA SCHULTZ<br />
199 HOME ROAD<br />
JUNEAU, WI 53039<br />
County: Dodge<br />
aschultz@co.dodge.wi.us<br />
Phone: (920) 386-3500<br />
Fax: (920) 386-3812<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 />
10/01/1975<br />
03/01/2011<br />
02/28/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Emergency Outpatient DHS 75.05<br />
CSAS-Outpatient Treatment DHS 75.13<br />
<strong>Mental</strong> <strong>Health</strong>-Emergency Service 3 DHS 34.3<br />
2688<br />
DOMINION BEHAVIORAL HEALTH SERVICES, LLC<br />
FRANCINE DIXON<br />
W132 N6303 MARACH ROAD<br />
MENOMONEE FALLS, WI 53051<br />
County: Waukesha<br />
franc<strong>in</strong>edixon@dom<strong>in</strong>ionllc.org<br />
Phone: (262) 751-7507<br />
Fax: (262) 252-7567<br />
Surveyor: Mark Isaacs<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 />
11/01/2006<br />
11/01/2011<br />
10/31/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
2159<br />
DOOR COUNTY DEPARTMENT OF COMMUNITY<br />
PROGRAMS COMMUNITY SUPPORT PROGRAM<br />
SHERYL FLORES<br />
421 NEBRASKA STREET<br />
STURGEON BAY, WI 54235<br />
County: Door<br />
dcp@co.door.wi.us<br />
Phone: (920) 746-2345<br />
Fax: (920) 746-2439<br />
Surveyor: William Goehr<strong>in</strong>g<br />
Services<br />
NO BRANCH LOCATIONS<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
03/01/2011 02/28/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
10/01/1999<br />
04/01/2011<br />
03/31/2013<br />
<strong>Mental</strong> <strong>Health</strong>-Community Support Program DHS 63<br />
NO BRANCH LOCATIONS<br />
11/01/2011 10/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
04/01/2011 03/31/2013
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