Cbrfraci.Pdf

Cbrfraci.Pdf

Wisconsin Department Division of Quality Assurance Directory 08/30/2021 of Health Services UdtdPage 1 Public Directory By Facility Name For Facility Type CBRF Racine Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs ARBOR VIEW COMMUNITIES (0017134) ARHC AVBURWI01 TRS LLC C/O HEALTHCARE T Type: CBRF ADVANCED AGED (212) 415-6500 Class: CNA 34201 ARBOR LN IRREVERSIBLE DEMENTIA/ALZHEIM BURLINGTON WI 53105 MICHELLE VIOL Gender - Capacity: M/F - 40 (262) 539-2728 MICHELLE VIOL 34201 ARBOR LN Low/High rate: 3,900/4,500 PHYSICALLY DISABLED County: RACINE BURLINGTON WI 53105 Initial License: 06/22/2018 TERMINALLY ILL TRAUMATIC BRAIN INJURY ARBOR VIEW MEMORY CARE (0017133) ARHC AVBURWI01 TRS LLC C/O HEALTHCARE T Type: CBRF ADVANCED AGED (212) 415-6500 Class: CNA 34111 ARBOR LN IRREVERSIBLE DEMENTIA/ALZHEIM BURLINGTON WI 53105 MICHELLE VIOL Gender - Capacity: M/F - 10 (262) 539-2738 MICHELLE VIOL 34111 ARBOR LN Low/High rate: 4,500/5,500 County: RACINE BURLINGTON WI 53105 Initial License: 06/22/2018 ASCENSION LIVING LAKESHORE AT SIENA (0017233) ASCENSION LIVING LAKESHORE AT SIENA INC Type: CBRF ADVANCED AGED (262) 898-9100 Class: CNA 5643 ERIE ST IRREVERSIBLE DEMENTIA/ALZHEIM RACINE WI 53402 JENNIFER BEZOTTE Gender - Capacity: M/F - 36 (262) 664-4876 JENNIFER BEZOTTE 1320 WISCONSIN AVE Low/High rate: 6,000/9,060 County: RACINE RACINE WI 53403 Initial License: 12/06/2019 CALEBRIA HOUSE (0015143) HIGH POINT ASSISTED LIVING LLC Type: CBRF HCBS COMPLIANT (262) 767-7300 Class: CNA 155 BETH COURT ADVANCED AGED BURLINGTON WI 53105 RICK WASMUND Gender - Capacity: M/F - 7 (262) 767-7300 RICK WASMUND 155 BETH COURT Low/High rate: 3,800/5,000 DEVELOPMENTALLY DISABLED County: RACINE BURLINGTON WI 53105 Initial License: 08/05/2014 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY EAGLE HOUSE (310369) COMMUNITY CONNECTION LLC Type: CBRF HCBS COMPLIANT (414) 906-1915 Class: AA 807 53RD DR ALCOHOL/DRUG DEPENDENT UNION GROVE WI 53182 ROBERT LIEBERMAN Gender - Capacity: M/F - 8 (262) 835-8370 ANGELA ANDERSEN 5225 N IRONWOOD LN STE 116 Low/High rate: 4,500/4,500 DEVELOPMENTALLY DISABLED County: RACINE GLENDALE WI 53217 Initial License: 10/10/1995 EMOTIONALLY DISTURBED/MENTAL TRAUMATIC BRAIN INJURY GENESIS CROSSROADS (310435) GENESIS BEHAVIORAL SERVICES INC Type: CBRF ALCOHOL/DRUG DEPENDENT (414) 377-3021 Class: AA 4107 4109 ST CLAIR ST CORRECTIONAL CLIENTS RACINE WI 53402 PATRICIA FAULHABER Gender - Capacity: F - 9 (414) 377-3021 PATRICIA FAULHABER 2819 W highland blvd Low/High rate: 2,499/2,499 EMOTIONALLY DISTURBED/MENTAL County: RACINE Milwaukee WI 53208 Initial License: 10/15/1990 PUBLIC FUNDING HIL FOX MEAD GROUP HOME (0009691) HOMES FOR INDEPENDENT LIVING OF WI LLC Type: CBRF HCBS COMPLIANT (262) 569-5515 Class: CNA 516 FOX MEAD CROSSING DEVELOPMENTALLY DISABLED WATERFORD WI 53185 LYNN MATZKE Gender - Capacity: M/F - 8 (262) 514-3500 KELLY THOMPSON 1249 RUSSETT COURT Low/High rate: 5,442/5,442 PHYSICALLY DISABLED County: RACINE GREEN BAY WI 54313 Initial License: 01/01/2002 PUBLIC FUNDING HIL HILLSIDE (0009760) HOMES FOR INDEPENDENT LIVING OF WI LLC Type: CBRF HCBS COMPLIANT (262) 569-5515 Class: CNA 373 CHURCH ST DEVELOPMENTALLY DISABLED BURLINGTON WI 53105 LYNN MATZKE Gender - Capacity: M/F - 8 (262) 569-5515 KELLY THOMPSON 1249 RUSSETT COURT Low/High rate: 5,675/5,675 PUBLIC FUNDING County: RACINE GREEN BAY WI 54313 Initial License: 01/01/2002 HIL KENDRICK HOME (0010610) HOMES FOR INDEPENDENT LIVING OF WI LLC Type: CBRF HCBS COMPLIANT (262) 569-5515 Class: CNA 265 N KENDRICK AVE DEVELOPMENTALLY DISABLED BURLINGTON WI 53105 LYNN MATZKE Gender - Capacity: M/F - 6 (262) 767-7411 KELLY THOMPSON 1249 RUSSETT COURT Low/High rate: 5,968/5,968 EMOTIONALLY DISTURBED/MENTAL County: RACINE GREEN BAY WI 54313 Initial License: 08/10/2005 PHYSICALLY DISABLED PUBLIC FUNDING HIL KENNEDY HOME (0012307) HOMES FOR INDEPENDENT LIVING OF WI LLC Type: CBRF HCBS COMPLIANT (262) 569-5515 Class: CNA 4305 4307 KENNEDY DR DEVELOPMENTALLY DISABLED RACINE WI 53404 LYNN MATZKE Gender - Capacity: M/F - 6 (262) 456-4279 KELLY THOMPSON 1249 RUSSETT COURT Low/High rate: 8,773/8,773 PHYSICALLY DISABLED County: RACINE GREEN BAY WI 54313 Initial License: 06/23/2008 PUBLIC FUNDING *The Community Based Residential Facility (CBRF) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/30/2021 of Health Services UdtdPage 2 Public Directory By Facility Name For Facility Type CBRF Racine Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs HIL WANDA FROGG VILLA/MEADOWHAVEN (0012315) HOMES FOR INDEPENDENT LIVING OF WI LLC Type: CBRF HCBS COMPLIANT (262) 569-5515 Class: CNA 524 SUMMIT AVE DEVELOPMENTALLY DISABLED BURLINGTON WI 53105 LYNN MATZKE Gender - Capacity: M/F - 6 (262) 767-0239 KELLY THOMPSON 1249 RUSSETT COURT Low/High rate: 4,589/4,589 EMOTIONALLY DISTURBED/MENTAL County: RACINE GREEN BAY WI 54313 Initial License: 06/03/2008 PHYSICALLY DISABLED PUBLIC FUNDING Association Approval: WALA LAKEVIEW CARE PARTNERS AT WATERFORD (0016391) LAKEVIEW CARE PARTNERS INC Type: CBRF ALCOHOL/DRUG DEPENDENT (262) 534-7292 Class: CNA 1701 SHARP RD DEVELOPMENTALLY DISABLED WATERFORD WI 53185 ANDY OLIVARES Gender - Capacity: M/F - 20 (262) 534-7297 ANDY OLIVARES 1701 SHARP RD Low/High rate: 5,131/22,500 PHYSICALLY DISABLED County: RACINE WATERFORD WI 53185 Initial License: 09/01/2016 PUBLIC FUNDING TRAUMATIC BRAIN INJURY LAKEVIEW CARE PARTNERS AT WATERFORD II (0016982 LAKEVIEW CARE PARTNERS INC Type: CBRF ADVANCED AGED (262) 534-7297 Class: CA 1701 SHARP RD ALCOHOL/DRUG DEPENDENT WATERFORD WI 53185 ANDY OLIVARES Gender - Capacity: M/F - 8 (262) 534-7297 ANDY OLIVARES 1701 SHARP RD Low/High rate: 8,998/54,750 DEVELOPMENTALLY DISABLED County: RACINE WATERFORD WI 53185 Initial License: 09/19/2018 TRAUMATIC BRAIN INJURY LAUREL HOUSE (310621) GENESIS BEHAVIORAL SERVICES INC Type: CBRF ALCOHOL/DRUG DEPENDENT (414) 892-4961 Class: AA 1725 1727 SPRING PL CORRECTIONAL CLIENTS RACINE WI 53404 PATRICIA FAULHABER Gender - Capacity: F - 12 (414) 892-4961 PATRICIA FAULHABER 6737 W WASHINGTON ST #2210 Low/High rate: 2,800/2,800 EMOTIONALLY DISTURBED/MENTAL County: RACINE WEST ALLIS WI 53214 Initial License: 10/01/1994 PUBLIC FUNDING LONG LAKE HOUSE (0011322) AFFINITY HEALTH CARE LLC Type: CBRF HCBS COMPLIANT (262) 895-3052 Class: AA 8208 RACINE AVE ALCOHOL/DRUG DEPENDENT WIND LAKE WI 53185 PAULA HEYER Gender - Capacity: M/F - 8 (262) 895-3052 THOMAS SCHILLING 8208 RACINE AVE Low/High rate: 4,500/6,000 DEVELOPMENTALLY DISABLED County: RACINE WIND LAKE WI 53185 Initial License: 08/30/2006 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY Association Approval: WALA MAGNOLIA HILL - MT PLEASANT C CBRF (0017186) STONE HILL GRAFTON LLC Type: CBRF HCBS COMPLIANT (312) 622-3266 Class: CNA 3820 OLD GREEN BAY RD ADVANCED AGED MOUNT PLEASANT WI 53403 JIM ZACHE Gender - Capacity: M/F - 8 (262) 226-2893 TAMARA MCCONNELL 314 E MAIN STREET Low/High rate: 4,149/6,500 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE WATERTOWN WI 53094 Initial License: 06/27/2018 PHYSICALLY DISABLED TERMINALLY ILL MAGNOLIA HILL MOUNT PLEASANT A L MEMORY CARE STONE HILL GRAFTON LLC Type: CBRF HCBS COMPLIANT (414) 763-7869 Class: CNA 3810 OLD GREEN BAY ROAD ADVANCED AGED MOUNT PLEASANT WI 53403 JIM ZACHE Gender - Capacity: M/F - 24 (262) 583-5134 Jim Zache 314 E MAIN ST Low/High rate: 4,500/6,000 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE WATERTOWN WI 53094 Initial License: 04/17/2020 PHYSICALLY DISABLED TERMINALLY ILL MAGNOLIA HILL - MT PLEASANT A CBRF (0017189) STONEHILL GRAFTON LLC Type: CBRF HCBS COMPLIANT (312) 622-3266 Class: CNA 3820 OLD GREEN BAY RD ADVANCED AGED MOUNT PLEASANT WI 53403 JIM ZACHE Gender - Capacity: M/F - 8 (262) 226-2893 Tamara McConnell 314 E MAIN STREET Low/High rate: 4,500/6,000 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE WATERTOWN WI 53094 Initial License: 06/27/2018 PHYSICALLY DISABLED TERMINALLY ILL MAGNOLIA HILL - MT PLEASANT B CBRF (0017188) STONE HILL GRAFTON LLC Type: CBRF HCBS COMPLIANT (312) 622-3266 Class: CNA 3820 OLD GREEN BAY RD ADVANCED AGED MOUNT PLEASANT WI 53403 JIM ZACHE Gender - Capacity: M/F - 8 (262) 226-2893 TAMARA MCCONNELL 314 E MAIN STREET Low/High rate: 4,500/6,000 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE WATERTOWN WI 53094 Initial License: 06/27/2018 PHYSICALLY DISABLED TERMINALLY ILL *The Community Based Residential Facility (CBRF) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/30/2021 of Health Services UdtdPage 3 Public Directory By Facility Name For Facility Type CBRF Racine Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs MAPLEWOOD APPLEWOOD COTTAGE (0015968) ELDER CARE COTTAGES OF WISCONSIN LLC Type: CBRF ADVANCED AGED (262) 895-2332 Class: CNA 7711 BIG BEND RD IRREVERSIBLE DEMENTIA/ALZHEIM WATERFORD WI 53185 CATHY FENNEMA Gender - Capacity: M/F - 30 (262) 895-2332 CATHY FENNEMA 7711 BIG BEND RD Low/High rate: 4,000/6,050 PHYSICALLY DISABLED County: RACINE WATERFORD WI 53185 Initial License: 04/28/2016 PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY NEW VISION HOME LLC II (0014935) NEW VISION ADULT FAMILY HOME LLC Type: CBRF HCBS COMPLIANT (262) 554-9566 Class: CNA 1449 N GREEN BAY ROAD ADVANCED AGED MT PLEASANT WI 53406 SHALANDA BEDFORD Gender - Capacity: M/F - 8 (262) 633-9920 ERICA MARKS PO BOX 085782 Low/High rate: 3,000/6,000 ALCOHOL/DRUG

View Full Text

Details

  • File Type
    pdf
  • Upload Time
    -
  • Content Languages
    English
  • Upload User
    Anonymous/Not logged-in
  • File Pages
    5 Page
  • File Size
    -

Download

Channel Download Status
Express Download Enable

Copyright

We respect the copyrights and intellectual property rights of all users. All uploaded documents are either original works of the uploader or authorized works of the rightful owners.

  • Not to be reproduced or distributed without explicit permission.
  • Not used for commercial purposes outside of approved use cases.
  • Not used to infringe on the rights of the original creators.
  • If you believe any content infringes your copyright, please contact us immediately.

Support

For help with questions, suggestions, or problems, please contact us