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 98 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
2492<br />
FAMILY AND CHILDREN'S CENTER JACKSON<br />
COUNTY COMMUNITY SUPPORT PROGRAM<br />
MIKE BOEHM<br />
409 COUNTY ROAD R<br />
BLACK RIVER FALLS, WI 54615<br />
County: Jackson<br />
mboehm@fccnetwork.org<br />
Phone: (715) 284-9477<br />
Fax: (715) 284-5547<br />
Surveyor: Polly Wong<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 />
01/01/2004<br />
01/01/2011<br />
12/31/2012<br />
<strong>Mental</strong> <strong>Health</strong>-Community Support Program DHS 63<br />
1317<br />
FAMILY AND CHILDREN'S CENTER, INC.<br />
COMMUNITY SUPPORT PROGRAM<br />
KATHY ROHR-NINMER<br />
1321 N MAIN ST<br />
VIROQUA, WI 54665<br />
County: Vernon<br />
kn<strong>in</strong>mer@fccnetwork.org<br />
Phone: (608) 637-7052<br />
Fax: (608) 637-8500<br />
Surveyor: Cynthia L<strong>in</strong>dgren<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 />
01/01/1996<br />
05/01/2011<br />
04/30/2013<br />
<strong>Mental</strong> <strong>Health</strong>-Community Support Program DHS 63<br />
1315<br />
FAMILY AND CHILDREN'S CENTER<br />
MIKE BOEHM<br />
1707 MAIN STREET<br />
LA CROSSE, WI 54601<br />
County: La Crosse<br />
mboehm@fccnetwork.org<br />
Phone: (608) 785-0001<br />
Fax: (608) 785-0002<br />
Surveyor: Polly Wong<br />
Services<br />
NO BRANCH LOCATIONS<br />
01/01/2011 12/31/2012<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
02/01/1994<br />
11/01/2010<br />
10/31/2012<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment for Children 1 DHS 40.11(2)(a)<br />
05/01/2011 04/30/2013<br />
FAMILY AND CHILDREN'S CENTER Tier 2<br />
1321 NORTH MAIN ST<br />
01/20/2012<br />
VIROQUA, WI 54665<br />
10/31/2012<br />
FAMILY AND CHILDREN'S CENTER Tier 1<br />
HWY 14 NORTH<br />
01/20/2012<br />
VIROQUA, WI 54665<br />
10/31/2012<br />
FAMILY AND CHILDREN'S CENTER Tier 2<br />
409 COUNTY RD R<br />
01/20/2012<br />
BLACK RIVER FALLS, WI 54615<br />
10/31/2012<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
11/01/2010 10/31/2012<br />
11/01/2010 10/31/2012<br />
11/01/2010 10/31/2012
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