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 88 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1283 DOOR COUNTY DEPARTMENT OF COMMUNITY PROGRAMS TINA MARIE BAETEN 421 NEBRASKA STREET STURGEON BAY, WI 54235 County: Door commprog@co.door.wi.us Phone: (920) 746-2345 Fax: (920) 746-2439 Surveyor: Frank Bellaire Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 01/01/1978 10/01/2010 09/30/2012 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 Mental Health-Emergency Service 3 DHS 34.3 2964 DOUGLAS CO DEPT HLTH & HUMAN SVS/HUMAN DEVELOPMENT CTR STEVEN ENGLESON 1500 N 34TH STREET, #200 SUPERIOR, WI 54880 County: Douglas steve.engleson@hdchrc.org Phone: (715) 392-8216 Fax: (715) 392-6055 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 07/01/2010 07/01/2010 06/30/2012 Mental Health-Emergency Service 2 DHS 34.2 2847 DOUGLAS COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES DAVE LONGSDORF 1316 N 14TH STREET SUITE 400 SUPERIOR, WI 54880 County: Douglas dave.longsdorf@douglascountywi.org Phone: (715) 395-1304 Fax: (715) 395-1370 Surveyor: Bradley Jahr Services NO BRANCH LOCATIONS 10/01/2010 09/30/2012 10/01/2010 09/30/2012 10/01/2010 09/30/2012 Administrative Code Chapter Service Begin/End Dates 01/06/2009 01/01/2011 12/31/2012 CSAS-Intervention DHS 75.16 NO BRANCH LOCATIONS 07/01/2010 06/30/2012 Administrative Code Chapter Service Begin/End Dates 01/01/2011 12/31/2012
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 89 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2659 DR. STRESS & ASSOCIATES, LLC BRIAN A STRESS PSY D 5840 ARNDT ROAD, #3 EAU CLAIRE, WI 54701 County: Eau Claire bstress@drstressassociates.com Phone: (715) 833-7111 Fax: (715) 833-0454 Surveyor: Polly Wong Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 03/28/2006 10/01/2011 03/31/2013 Mental Health Outpatient Clinic DHS 35 2064 DULUTH DETOXIFICATION CENTER TINA SILVERNESS-ZINMER 1402 E. SUPERIOR STREET DULUTH, MN 55802 County/State: Saint Louis, MN Tina@cadt.org Phone: (218) 529-3426 Fax: (218) 529-3440 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 09/01/1998 11/01/2010 10/31/2012 CSAS-Medically Monitored Residential Detox DHS 75.07 1287 DUNN COUNTY DEPARTMENT OF HUMAN SERVICES BEHAVIORAL HEALTH SERVICES VICKI RADMANN 808 MAIN STREET MENOMONIE, WI 54751 County: Dunn vradmann@co.dunn.wi.us Phone: (715) 231-2706 Fax: (715) 232-5987 Surveyor: Polly Wong Services NO BRANCH LOCATIONS 10/01/2011 03/31/2013 Administrative Code Chapter Service Begin/End Dates 01/01/1981 06/01/2012 05/31/2014 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 11/01/2010 10/31/2012 Administrative Code Chapter Service Begin/End Dates 06/01/2012 05/31/2014
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