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Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 1

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA M/F - 44 Low/High rate: 2,000/2,200 Initial License: 05/31/1996 CBRF CNA M/F - 17 Low/High rate: 2,000/4,000 Initial License: 07/01/2011 CBRF CNA M/F - 8 Low/High rate: 3,390/5,640 Initial License: 12/01/2012 CBRF CNA M/F - 15 Low/High rate: 2,000/4,000 Initial License: 07/01/2011 CBRF CNA M/F - 17 Low/High rate: 3,390/5,640 Initial License: 11/01/2011

Type: Class: Type: Class: Type: Class: Type: Class: Type: Class:

LIBERTY MANOR INC (110551) 550 W LIBERTY ST ADAMS WI 53910 (608) 339-9444 VALORIE L SCHABLE County: ADAMS BEARS HOLLOW (0013776) 1019 15TH AVE WEST ASHLAND WI 54806 (715) 292-6411 DALE KELM County: ASHLAND EAGLES RIDGE (0014196) 224 22ND AVE W ASHLAND WI 54806 (715) 292-6316 DALE KELM County: ASHLAND FALCONS CREST (0013775) 218 22ND AVE WEST ASHLAND WI 54806 (715) 292-6444 DALE KELM County: ASHLAND TIMBERS EDGE (0013908) 1500-10TH ST ASHLAND WI 54806 (715) 292-6314 DALE KELM County: ASHLAND

VALORIE L SCHABLE (920) 295-3438 VALORIE SCHABLE 550 W LIBERTY ST ADAMS WI 53910 BIRCH HAVEN SENIOR LIVING, INC (715) 292-6313 DALE KELM 218 22ND AVE WEST ASHLAND WI 54806 BIRCH HAVEN SENIOR LIVING INC (715) 292-6316 DALE KELM 224 22ND AVE W ASHLAND WI 54806 BIRCH HAVEN SENIOR LIVING, INC (715) 292-6313 DALE KELM 218 22ND AVE WEST ASHLAND WI 54806 BIRCH HAVEN SENIOR LIVING INC (715) 292-6313 DALE KELM 224-22ND AVE W ASHLAND WI 54806

Gender - Capacity:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Gender - Capacity:

Gender - Capacity:

Gender - Capacity:

Gender - Capacity:

AURORA RES ALTERNATIVES INC 049 (510300) 1849 HWY 63 COMSTOCK WI 54826 (715) 822-2245 JILL MATTSON County: BARRON BRENTWOOD SENIOR COMMUNITIES - MEMORY CARE ( 633 CAMERON RD RICE LAKE WI 54868 (715) 736-7400 RUTH ROTHSTEIN County: BARRON CARE PARTNERS ASSISTED LIVING LLC (0009050) 1627 KERN AVENUE RICE LAKE WI 54868 (715) 234-7719 DEB SEVERSON County: BARRON CHETEK RIVERS EDGE (0011663) 251 WOODWARD ST CHETEK WI 54728 (715) 924-2964 ERIC MARSHALL County: BARRON CHRISMARK HOME LLC (0011891) 910 MELNORA ST RICE LAKE WI 54868 (715) 736-1112 MARY MINER County: BARRON COUNTRY TERRACE OF WISCONSIN INC (0009581) 1631 KERN AVENUE RICE LAKE WI 54868 (715) 234-2012 DEB SEVERSON County: BARRON HANSENS GROUP HOME (510307) 1190 17TH ST BARRON WI 54812 (715) 537-5331 SUSAN & CARL HANSEN County: BARRON

AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DRIVE E SUITE B MENOMONIE WI 54751 DAVID BARTA (715) 537-3393 DAVID BARTA PO BOX 155 BARRON WI 54812 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54920 INTEGRICARE INC. (715) 859-6309 ERIC MARSHALL 1372-24-3/8TH ST CAMERON WI 54822 MARY/WALT MINER (715) 234-3506 MARY MINER 304 RICHTER ST RICE LAKE WI 54868 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903-3006 SUSAN HANSEN (715) 537-5331 SUSAN HANSEN 1190 17TH ST BARRON WI 54812

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 4,775/5,688 Initial License: 01/01/1994 CBRF CNA M/F - 20 Low/High rate: 3,700/6,000 Initial License: 10/22/2012 CBRF CNA M/F - 15 Low/High rate: 1,995/3,495 Initial License: 06/01/2000 CBRF CNA M/F - 8 Low/High rate: 2,900/5,000 Initial License: 09/19/2006 CBRF AA F-8 Low/High rate: 2,700/3,000 Initial License: 03/23/2007 CBRF CNA M/F - 16 Low/High rate: 2,652/3,702 Initial License: 03/01/2002 CBRF AA M/F - 7 Low/High rate: 1,500/4,000 Initial License: 02/12/1985

Type: Class: Type: Class: Type: Class: Type: Class: Type: Class: Type: Class:

Type: Class:

Gender - Capacity:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

Gender - Capacity:

Gender - Capacity:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

Gender - Capacity:

ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 2

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,940/3,954 Initial License: 04/24/2009

Type: Class:

HUNTER HOME SERVICES INC (0012722) 1222 - 13-1/2 AVENUE BARRON WI 54812 (715) 537-1608 MARY ARDINES County: BARRON INTEGRICARE - CAMERON (0013020) 1372-24-3/8 ST CAMERON WI 54822 (715) 859-6309 ERIC MARSHALL County: BARRON INTEGRICARE - RICE LAKE (0014017) 315 E. SAINT PATRICK ST RICE LAKE WI 54868 (715) 719-0024 ERIC MARSHALL County: BARRON MAGNA HOUSE OF BARRON COUNTY LLC (0014442) 615 E SAWYER ST RICE LAKE WI 54868 (715) 736-6334 KAREN RUSCH County: BARRON MONROE MANOR (510311) 508 E MONROE AVE BARRON WI 54812 (715) 537-5700 JULIE MALONE County: BARRON NEW BEGINNINGS OF BARRON COUNTY INC (0009905) 4 CORNELL AVENUE RICE LAKE WI 54868 (715) 736-1311 DEBRA JANISCH County: BARRON NORTHWOOD GABLES (0013523) 1464-21ST AVENUE RICE LAKE WI 54868 (715) 234-9415 BETTY JOHNSON County: BARRON OUR HOUSE ASSISTED CARE (0013421) 415 E SOUTH ST RICE LAKE WI 54868 (715) 236-7211 LYNN HUNT County: BARRON OUR HOUSE MEMORY CARE (0013426) 413 E SOUTH ST RICE LAKE WI 54868 (715) 736-0347 LIZA PRUST County: BARRON THOMAS LANDING CBRF (0012947) 950 BEAR PAW AVENUE RICE LAKE WI 54868 (715) 736-6060 SUE JUTZ County: BARRON MISHOMIS HOUSE (610278) 37390 N BRADUM RD BAYFIELD WI 54814 (715) 779-3742 MARTIN GORDON County: BAYFIELD OAKS AT NORTHERN LIGHTS (THE) (0012705) 702 BRATLEY DR WASHBURN WI 54891 (715) 373-5621 JENNIFER AUGUSTINE County: BAYFIELD Association Approval: Leading Age

HUNTER HOME SERVICES INC (651) 332-0010 ELIZABETH HUNTER 6087-27 ST N OAKDALE MN 55128 INTEGRICARE INC (715) 790-4727 ERIC MARSHALL 1372-24-3/8 ST CAMERON WI 54822 INTEGRICARE, INC. (715) 790-4727 ERIC MARSHALL 1372-24 3/8 STREET CAMERON WI 54822 MAGNA HOUSE OF BARRON COUNTY LLC (715) 292-0497 KAREN RUSCH 2311 20 1/2 STREET RICE LAKE WI 54868 VANYO INC (507) 387-4628 VANYO MOODY 200 BELGRADE AVE APT 4 MANKATO MN 56001 DEBRA JANISCH (715) 354-3840 DEBRA JANISCH 4 CORNELL AVE RICE LAKE WI 54868 NORTHWOOD GABLES LLC (715) 520-2909 NANCY FREDRICKSON 1464-21ST AVENUE RICE LAKE WI 54868 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 WELCOME HOME HEALTH CARE INC (320) 587-0005 ROMAN BLOEMKE P O BOX 172 HUTCHINSON MN 55350 RED CLIFF BAND OF LAKE SUPERIOR CHIPPEW (715) 779-3700 MARTIN GORDON 88385 PIKE ROAD HWY 13 BAYFIELD WI 54814 NORTHERN LIGHTS SERVICES (715) 373-5621 EUGENE JORDAN 706 BRATLEY DR WASHBURN WI 54891

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,700/4,200 Initial License: 10/30/2009

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF ANA Gender - Capacity: M/F - 6 Low/High rate: 2,900/5,500 Initial License: 09/03/2012

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,280/3,900 Initial License: 12/12/2012

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 82 Low/High rate: 2,850/3,700 Initial License: 06/19/1984

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,300/6,000 Initial License: 12/19/2002

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,235/4,813 Initial License: 09/27/2010

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,250/3,620 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

Gender - Capacity:

CBRF CNA M/F - 24 Low/High rate: 3,800/3,800 Initial License: 09/30/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 39 Low/High rate: 4,160/6,240 Initial License: 09/18/2009

Type: Class:

Gender - Capacity:

CBRF AA M/F - 12 Low/High rate: 1,200/2,100 Initial License: 03/06/1995

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 17 Low/High rate: 3,400/3,750 Initial License: 03/20/2009

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 3

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,000/4,000 Initial License: 09/01/2010

Type: Class:

WILLOW MANOR (0013334) 68290 N DISTRICT ST IRON RIVER WI 54847 (715) 372-5005 SHARON HOGFELDT County: BAYFIELD ACS - GREEN BAY (0011996) 2670 UNIVERSITY AVE GREEN BAY WI 54311 (920) 469-2569 KATRINA NELSON County: BROWN ALLOUEZ PARKSIDE VILLAGE (0013195) 1901 LIBAL ST GREEN BAY WI 54301 (920) 430-8500 JACQUELINE LARDINOIS County: BROWN ALPHA SENIOR CONCEPTS (0013802) 2723 LINEVILLE RD HOWARD WI 54313 (920) 393-4531 JEAN HOWARD County: BROWN ANGELS ON ARCADIAN 1 (0014000) 1550 ARCADIAN LN DE PERE WI 54115 (920) 339-0601 DAVID FRY County: BROWN ANGELS ON ARCADIAN 2 (0014001) 1500 ARCADIAN LN DE PERE WI 54115 (920) 339-0601 DAVID FRY County: BROWN ANGELS ON ARCADIAN 3 (0014002) 1525 ARCADIAN LN DE PERE WI 54115 (920) 339-0601 DAVID FRY County: BROWN

WILLOW MANOR INC (715) 372-5005 SHARON HOGFELDT 68290 N DISTRICT ST IRON RIVER WI 54847 ACS CLINICAL SERVICES LLC (608) 223-0017 KATHY JOHNSON 107 4TH ST BARABOO WI 53913-2148 HILLCREST PROPERTIES LTD (920) 337-2450 HARRY MACCO 2986 COUNTY RD PP DE PERE WI 54115 A'VIEW SENIOR LIVING (920) 366-6221 JEAN HOWARD 3075 FALCON RIDGE TRL SUAMICO WI 54313 DEC COMPANY LLC (920) 217-6601 DAVID FRY 3200 HARBOR WINDS DR SUAMICO WI 54173 DEC COMPANY LLC (920) 217-6601 DAVID FRY 3200 HARBOR WINDS DR SUAMICO WI 54173 DEC COMPANY LLC (920) 217-6601 DAVID FRY 3200 HARBOR WINDS DR SUAMICO WI 54173

ADVANCED AGED

CBRF AS Gender - Capacity: M/F - 15 Low/High rate: 2,374/2,629 Initial License: 08/31/2007

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED ALCOHOL/DRUG DEPENDENT IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 55 Low/High rate: 3,500/4,800 Initial License: 03/26/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 39 Low/High rate: 4,000/5,900 Initial License: 10/07/2011

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,600/4,000 Initial License: 01/01/2012 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,600/4,000 Initial License: 01/01/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,600/4,000 Initial License: 01/01/2012

Type: Class:

ANGELS TOUCH ASSISTED LIVING LLC (0011771) 394 ANGELS TOUCH CT DE PERE WI 54115 (920) 676-2307 SHEILA STEINFELDT County: BROWN ANGELS TOUCH ASST LVG LLC 5 (0012845) 400 ANGELS TOUCH CT DE PERE WI 54115 (920) 339-0601 SHEILA STEINFELDT County: BROWN ANNAS HEALTHCARE INC 1 (410494) 5449 CTH K NEW FRANKEN WI 54229 (920) 866-2903 TAMA BEGLEY County: BROWN

ANGELS TOUCH ASSISTED LIVING LLC (920) 676-2307 SHEILA STEINFELDT 394 ANGELS TOUCH CT DE PERE WI 54115 ANGELS TOUCH (920) 339-0601 SHEILA STEINFELDT 394 ANGELS TOUCH CT DE PERE WI 54115 BEGLEY (920) 866-9803 TAMA BEGLEY 4999 PLACID WAY NEW FRANKEN WI 54229

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/4,200 Initial License: 06/13/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/4,500 Initial License: 06/11/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,070/3,200 Initial License: 01/09/1997

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 4

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: F - 36 Low/High rate: 1,837/3,500 Initial License: 10/18/2002

Type: Class:

ANNAS HEALTHCARE INC 2 (0009766) 5449 CTY K NEW FRANKEN WI 54229 (920) 866-2903 TAMA BEGLEY County: BROWN

BEGLEY (920) 866-9803 TAMA BEGLEY 4999 PLACID WAY NEW FRANKEN WI 54229

ANNAS HEALTHCARE INC 3 (410271) 5453 CTY K NEW FRANKEN WI 54229 (920) 866-2338 TAMA BEGLEY County: BROWN

BEGLEY (920) 866-9803 TAMA BEGLEY 4999 PLACID WAY NEW FRANKEN WI 54229

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,000/3,500 Initial License: 11/01/1991

Type: Class:

ARTISAN DE PERE (THE) (0014426) 1880 SCHEURING RD DE PERE WI 54115 (920) 338-3407 NANCY KUSTKA County: BROWN BIRCH CREEK BY HILLCREST (0009591) 525 N 10TH ST DE PERE WI 54115 (920) 964-3737 JACQUELINE LARDINOIS County: BROWN

MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 MACCO (920) 337-2455 HARRY MACCO 2986 CTY RD PP DE PERE WI 54115

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 2,900/3,800 Initial License: 12/01/2012

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 74 Low/High rate: 1,900/5,000 Initial License: 04/19/2002

Type: Class:

BISHOPS COURT (410493) 289 E ST JOSEPH ST GREEN BAY WI 54301 (920) 435-2729 JACQUELINE LARDINOIS County: BROWN

MACCO (920) 337-2450 JACQUELINE LARDINOIS 289 E ST JOSEPH ST GREEN BAY WI 54301

Gender - Capacity:

CBRF CNA M/F - 69 Low/High rate: 3,200/4,500 Initial License: 09/23/1997

Type: Class:

BORNEMANN CBRF NORTH (0011045) 1866 BROOK ST GREEN BAY WI 54302 (920) 406-9850 BONNIE DAVIS County: BROWN BORNEMANN CBRF SOUTH (0009684) 1853 MILLS ST GREEN BAY WI 54302 (920) 468-8675 BONNIE DAVIS County: BROWN CARDINAL RIDGE RESIDENTIAL CARE (0010029) 713 CARDINAL LANE GREEN BAY WI 54313 (920) 434-9600 KAREN BAIN County: BROWN CARE FOR ALL AGES (0010060) 1308 S NORWOOD GREEN BAY WI 54304 (920) 432-8119 BECKIE ROTTIER County: BROWN CARRINGTON MANOR (0011878) 2626 FINGER RD GREEN BAY WI 54302 (920) 469-2606 MARILYN LANCE County: BROWN

BORNEMANN NURSING HOME INC (920) 468-8675 BONNIE DAVIS 226 BORNEMANN ST GREEN BAY WI 54302 BORNEMANN NURSING HOME INC (920) 468-8675 BONNIE DAVIS 226 BORNEMANN ST GREEN BAY WI 54302 CARDINAL RIDGE RESIDENTIAL CARE (920) 434-9600 KAREN BAIN PO BOX 11966 GREEN BAY WI 54307-1966 CFAA INC (920) 432-8284 BECKIE ROTTIER 1308 S NORWOOD GREEN BAY WI 54304 CARRINGTON MANOR ASSISTED LIVING OF GR (312) 357-1601 BRENT HOLMAN-GOMEZ 125 S WACKER DR STE 1800 CHICAGO IL 60606

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,810/4,110 Initial License: 06/01/2006

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,300/3,750 Initial License: 08/13/2002

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 2,625/3,400 Initial License: 04/01/2003 CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 2,500/2,700 Initial License: 05/02/2003

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,833/3,500 Initial License: 05/01/2007

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 5

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,200/3,100 Initial License: 05/10/2012

Type: Class:

CENTURY RIDGE OF GREEN BAY I (0014023) 2498 BLUESTONE PL GREEN BAY WI 54311 (920) 468-2520 JENNIFER CRAWFORD County: BROWN CENTURY RIDGE OF GREEN BAY II (0014024) 2510 BLUESTONE PL GREEN BAY WI 54311 (920) 468-2520 JENNIFER CRAWFORD County: BROWN CLARITY CARE BERNARD ON HOFFMAN (0008949) 898 E HOFFMAN RD GREEN BAY WI 54301 (920) 338-1569 LORI HINZ County: BROWN CLARITY CARE SHAWANO AVENUE APARTMENTS (41044 1297 SHAWANO AVE GREEN BAY WI 54303 (920) 490-4581 ALLISON PIERSON County: BROWN COOPERS RUN (0013270) 2460 FORESTVILLE DR GREEN BAY WI 54304 (920) 544-0226 KELLY ZIPPERER County: BROWN COTTAGE LIVING AT MARLA VISTA GARDENS (0012183) 1016 N MILITARY AVE GREEN BAY WI 54303 (920) 405-0632 BARBARA BITTNER County: BROWN DURHAM (0014170) 2671-2673 DURHAM RD GREEN BAY WI 54311 (920) 884-3160 LORI HINTZ County: BROWN GRANCARE GARDENS (0012738) 1551 DOUSMAN ST GREEN BAY WI 54303 (920) 494-3050 DONNA ZUNKER County: BROWN HAMPTON MANOR (410565) 1265 ROCKWELL RD GREEN BAY WI 54313 (920) 434-9666 JANE NEWLUN County: BROWN HARBOR HOUSE GREEN BAY (0013436) 2500 BEL MEADOW DR GREEN BAY WI 54311 (920) 391-1820 REBECCA MINNICK County: BROWN HARMONY OF DENMARK (0008758) 346 SCANDINAVIAN CT DENMARK WI 54208 (920) 863-5362 KRISTINE RITZENHEIN County: BROWN Association Approval: WiCAL HARMONY OF GREEN BAY (0008950) 1450 S MILITARY AVE GREEN BAY WI 54304 (920) 499-8838 KRISTINE RITZENHEIN County: BROWN Association Approval: WiCAL

CENTURY RIDGE OF GREEN BAY INC (920) 468-2520 JILL BAETEN 2498 BLUESTONE PL GREEN BAY WI 54311 CENTURY RIDGE OF GREEN BAY INC (920) 468-2520 JILL BAETEN 2510 BLUESTONE PL GREEN BAY WI 54311 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 HOMES FOR INDEPENDENT LIVING OF WI LLC (920) 499-7965 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 LANCASTER MANOR ASSISTED LIVING OF GRE (312) 357-1601 BRENT HOLMAN GOMEZ 125 S WACKER DR STE 1800 CHICAGO IL 60606 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 DONALD & DONNA ZUNKER (920) 494-4525 DONNA ZUNKER 1555 DOUSMAN ST GREEN BAY WI 54303 ADULT CARE LIVING OF NEW LLC (920) 434-9666 JANE NEWLUN 1265 ROCKWELL RD GREEN BAY WI 54313 AZURA GREEN BAY LLC (920) 391-1820 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,200/3,100 Initial License: 05/10/2012

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: F - 6 Low/High rate: 6,477/6,477 Initial License: 06/23/2000 CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 5,570/5,683 Initial License: 01/29/1996

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 6,228/6,228 Initial License: 04/12/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,550/4,750 Initial License: 11/05/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,595/6,595 Initial License: 08/13/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,175/3,750 Initial License: 05/01/2009

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,156/2,800 Initial License: 11/03/1998

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 1,978/2,920 Initial License: 07/01/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 35 Low/High rate: 2,207/3,625 Initial License: 02/01/2000

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 6

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 4,400/4,900 Initial License: 06/13/2011

Type: Class:

HERITAGE GARDENS (0013713) 1207 S JACKSON ST GREEN BAY WI 54301 (920) 593-7000 CHARLENE EVERETT County: BROWN Association Approval: Leading Age HIL BITTERWOOD (0009689) 3279 BITTERS CT GREEN BAY WI 54301 (920) 983-0014 PENNI OLSON County: BROWN HIL MAPLE CREST (0011664) 825 GOLDEN EAGLE CT PULASKI WI 54162 (920) 822-1571 PENNI OLSON County: BROWN HIL ROCKWOOD HEIGHTS (0009812) 2744 ROCKWOOD HEIGHTS GREEN BAY WI 54313 (920) 662-1203 DAWN KNISKERN County: BROWN HIL WESTPLAIN (0014177) 335-339 WESTPLAIN DR GREEN BAY WI 54303 (920) 857-3734 LYNN MATZKE County: BROWN INNOVATIVE SERVICES INC DIVERSION FACILITY (00132 1311 N DANZ AVE GREEN BAY WI 54302 (920) 435-3750 RYAN PARYS County: BROWN

ODD FELLOW REBEKAH HOME ASSOC INC (920) 593-1640 CHARLENE EVERETT 1207 S JACKSON ST GREEN BAY WI 54301 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 HOMES FOR INDEPENDENT LIVING OF WI LLC (920) 609-8055 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 INNOVATIVE SERVICES INC (828) 684-8441 RYAN PARYS 445 S MADISON ST GREEN BAY WI 54301

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 6,323/6,323 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,472/6,472 Initial License: 10/02/2006

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 5,564/5,564 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 200/700 Initial License: 06/13/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,396/3,396 Initial License: 09/22/2010

Type: Class:

KINDREDHEARTS GREEN BAY (0010819) 653 WOODSIDE RD GREEN BAY WI 54311 (920) 406-7600 JENNI FABRY County: BROWN KINDREDHEARTS GREEN BAY (0010818) 655 WOODSIDE RD GREEN BAY WI 54311 (920) 465-7600 JENNI FABRY County: BROWN LIBAL STREET HOME (0011145) 3500 LIBAL ST GREEN BAY WI 54301 (920) 347-4624 RYAN PARYS County: BROWN

PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 JENNI FABRY 653 WOODSIDE RD GREEN BAY WI 54311 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 JENNI FABRY 655 WOODSIDE RD GREEN BAY WI 54311 INNOVATIVE SERVICES INC (920) 431-0962 RYAN PARYS 445 S MADISON ST GREEN BAY WI 54301

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 2,700/4,600 Initial License: 01/01/2005

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,600 Initial License: 01/01/2005 CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 8,435/8,435 Initial License: 12/16/2005

Type: Class:

LONGVIEW TERRACE I (410524) 3136 LONGVIEW LN SUAMICO WI 54173 (920) 434-8650 JASON TEGGE County: BROWN

COUNTRY HEALTHCARE INC (920) 662-7535 DEBRA TEGGE PO BOX 190 SUAMICO WI 54173

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,000/2,650 Initial License: 04/06/1998

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 7

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 1,750/2,550 Initial License: 12/30/1999

Type: Class:

LONGVIEW TERRACE II (0008920) 3136 LONGVIEW LN BLDG B SUAMICO WI 54173 (920) 662-0470 WAYLENE SANTSPREE County: BROWN

COUNTRY HEALTHCARE INC (920) 662-7535 DEBRA TEGGE PO BOX 190 SUAMICO WI 54173

LSS NORTH VIEW HOUSE (410213) 2517-19 N VIEW CT GREEN BAY WI 54303 (920) 494-5454 LISA SEVERSON County: BROWN LSS PREBLE HOUSE (410202) 830-832 EDGEWOOD DR GREEN BAY WI 54311 (920) 465-9977 LISA SEVERSON County: BROWN MARLA VISTA MANOR (0011875) 1006 N MILITARY AVE GREEN BAY WI 54303 (920) 499-1119 LESLIE SCHISEL County: BROWN MATTHEWS OF WRIGHTSTOWN (0014162) 510 MEADOW LN WRIGHTSTOWN WI 54180 (920) 532-0375 JENNIFER VANDEBOOGARD County: BROWN

LUTHERAN SOC SERV OF WI & UPPER MI INC (920) 730-1341 TED HAKALA 3003-A N RICHMOND ST APPLETON WI 54911 LUTHERAN SOC SERV OF WI & UPPER MI INC (920) 730-1341 TED HAKALA 3003-A N RICHMOND ST APPLETON WI 54911 MARLA VISTA ASSISTED LIVING OF GREEN BA (312) 357-1601 BRENT HOLMAN-GOMEZ 125 S WACKER DR STE 1800 CHICAGO IL 60606 MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 7,776/7,776 Initial License: 12/08/1989

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,966/4,966 Initial License: 11/06/1989

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 2,833/3,550 Initial License: 05/01/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,000/4,712 Initial License: 06/15/2012

Type: Class:

MC CORMICK MEMORIAL HOME (410199) 212 IROQUOIS AVE GREEN BAY WI 54301 (920) 437-0883 JAMES GENRICH County: BROWN Association Approval: Leading Age OAKS FAM CARE CTR CARI HOUSE (410014) 1485 PLYMOUTH LN GREEN BAY WI 54303 (920) 497-2477 LISA WANEK County: BROWN OAKS FAM CARE CTR CHRISTIANA (410158) 1643 CHRISTIANA ST GREEN BAY WI 54303 (920) 499-8641 DAVID WICKMAN County: BROWN OAKS FAM CARE CTR DAMIAN HOUSE (410097) 1481 PLYMOUTH LANE GREEN BAY WI 54303 (920) 494-3804 LISA WANEK County: BROWN OAKS FAM CARE CTR GRANT ST (410174) 1527 GRANT ST DE PERE WI 54115 (920) 336-3155 CYNDI GARBISCH County: BROWN

MC CORMICK MEM HOME FOR AGED INC (920) 437-0883 JAMES GENRICH 212 IROQUOIS AVE GREEN BAY WI 54301 G & I OCHS INC DBA OAKS FAMILY CARE CENTE (920) 497-0194 CYNDI GARBISCH 550 N MILITARY AVE #13 GREEN BAY WI 54303 G & I OCHS INC DBA OAKS FAMILY CARE CENTE (920) 497-0194 CYNTHIA GARBISCH 550 N MILIRARY AVE #13 GREEN BAY WI 54303 G & I OCHS INC DBA OAKS FAMILY CARE CENTE (920) 497-0194 CYNDI GARBISCH 550 N MILITARY AVE #13 GREEN BAY WI 54303 G & I OCHS INC DBA OAKS FAMILY CARE CENTE (920) 497-0194 CYNDI GARBISCH 550 N MILITARY AVE STE 13 GREEN BAY WI 54303

CBRF CNA Gender - Capacity: M/F - 56 Low/High rate: 2,595/3,195 Initial License: 05/10/1990

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M-6 Low/High rate: 2,928/2,928 Initial License: 10/03/1980

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CS M-8 Low/High rate: 2,549/2,549 Initial License: 07/01/1986

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AS F-7 Low/High rate: 2,431/2,431 Initial License: 10/02/1980

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CA M-6 Low/High rate: 3,105/4,489 Initial License: 12/09/1988

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 8

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

CBRF G & I OCHS INC DBA OAKS FAMILY CARE CENTE CA (920) 497-0194 Gender - Capacity: M - 7 CYNDI GARBISCH Low/High rate: 3,291/3,291 550 N MILITARY AVE #13 Initial License: 09/01/1988 GREEN BAY WI 54303

Type: Class:

Specialty Programs

OAKS FAM CARE CTR OAKLAND HOUSE (410156) 126 N OAKLAND AVE GREEN BAY WI 54303 (920) 432-1555 VENUS ROBERTSON County: BROWN ORIOLE (0013593) 503 PLATTEN ST GREEN BAY WI 54303 (920) 857-9718 KELLY ZIPPERER County: BROWN OUR PLACE (0009922) 1501 N IRWIN ST GREEN BAY WI 54302 (920) 438-7146 TANA KOSS County: BROWN PATIENT PINES ASSISTED LIVING INC 1715 (0013896) 1715 WESTMINSTER DR GREEN BAY WI 54302-5431 (920) 884-2273 BARBARA ZAMBON County: BROWN PATIENT PINES ASSISTED LIVING INC 1721 (0013897) 1721 WESTMINSTER DR GREEN BAY WI 54302-5431 (920) 884-3263 BARBARA ZAMBON County: BROWN RIDGE POINTE CBRF (0012658) 204 S ONEIDA ST GREEN BAY WI 54303 (920) 884-3192 KEVIN LAPOINTE County: BROWN SCHUMACHER HOUSE (0010929) 2831 FERNDALE DRIVE GREEN BAY WI 54313 (920) 497-9110 SHAWN COLLARD County: BROWN SERVAIS POINTE CBRF (0013912) 1398 SERVAIS ST GREEN BAY WI 54304 (920) 884-2366 KEVIN LAPOINTE County: BROWN SHERWOOD PLACE (0010552) 4893 FINGER RD GREEN BAY WI 54311 (920) 863-3665 KIERSTEN KARLSEN County: BROWN TENDER HEARTS ASSISTED LIVING LLC BLG NO 1 (0012 300 CARDINAL LN GREEN BAY WI 54313 (920) 366-8500 RACHEL GOFFARD County: BROWN TENDER HEARTS ASSISTED LIVING LLC BLG NO 2 (0013 320 CARDINAL LN GREEN BAY WI 54313 (920) 366-8500 RACHEL GOFFARD County: BROWN

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

HOMES FOR INDEPENDENT LIVING OF WIS LLC (920) 499-7965 LYNN MATZKE 1249 RUSSETT COURT GREEN BAY WI 54313 FAMILY SERVICES OF NE WIS INC (920) 436-6800 LOIS MISCHLER 300 CROOKS ST GREEN BAY WI 54301 TONI CARTER (920) 336-7308 BARBARA ZAMBON 2988 LEDGEVIEW RD DE PERE WI 54115 TONI CARTER (920) 336-7308 BARBARA ZAMBON 2988 LEDGEVIEW RD DE PERE WI 54115 COMPASS DEVELOPMENT LLC (920) 405-9010 KEVIN LAPOINTE 2029 TRUE LN GREEN BAY WI 54304 INNOVATIVE SERVICES INC (828) 684-8441 RYAN PARYS 445 S MADISON ST GREEN BAY WI 54301 COMPASS DEVELOPMENT LLC (920) 405-9010 KEVIN LAPOINTE 2029 TRUE LANE GREEN BAY WI 54304 PRODUCTIVE LIVING SYSTEMS INC (715) 831-3910 KIERSTEN KARLSEN 300 N WOODSEDGE DR STE 103 APPLETON WI 54914 TENDER HEARTS ASSISTED LIVING LLC (920) 366-8500 RACHEL GOFFARD 300 CARDINAL LN GREEN BAY WI 54313 TENDER HEARTS ASSISTED LIVING LLC (920) 857-9881 RACHEL GOFFARD 300 CARDINAL LN GREEN BAY WI 54313

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,276/6,276 Initial License: 12/21/2010

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 18 Low/High rate: 2,475/2,475 Initial License: 12/17/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,900/4,900 Initial License: 11/02/2011

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,900/4,900 Initial License: 11/08/2011

Type: Class: Type: Class:

CBRF CS Gender - Capacity: M/F - 5 Low/High rate: 5,400/6,000 Initial License: 03/25/2009 CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 6,414/6,414 Initial License: 03/31/2005

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 5 Low/High rate: 5,300/6,000 Initial License: 10/10/2011

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,490/5,673 Initial License: 06/15/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,800/4,200 Initial License: 08/25/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,800/4,300 Initial License: 09/21/2011

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 9

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,050/2,600 Initial License: 06/07/1999

Type: Class:

WOODHAVEN MANOR (0008722) 260 N ST AUGUSTINE ST PULASKI WI 54162 (920) 822-1300 DEBRA TEGGE County: BROWN

COUNTRY HEALTHCARE INC (920) 662-7535 DEBRA TEGGE PO BOX 190 SUAMICO WI 54173

WOODSIDE MANOR I II III (410168) 1060 PILGRIM WAY GREEN BAY WI 54304 (920) 499-7560 CONNIE PASCHOUWER County: BROWN

BAY AREA LUTHERAN HOMES INC (920) 499-1481 CONNIE PASCHOUWER 1060 PILGRIM WAY GREEN BAY WI 54304

CBRF CNA Gender - Capacity: M/F - 120 Low/High rate: 3,000/3,300 Initial License: 09/12/1988

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED PHYSICALLY DISABLED

Association Approval: Leading Age WYNDEMERE EAST (410518) 2999 RIVERSIDE DR GREEN BAY WI 54301 (920) 337-9434 KERRY MONFORT County: BROWN WYNDEMERE ESTATE (410314) 3001 RIVERSIDE DR GREEN BAY WI 54301 (920) 337-9434 KERRY MONFORT County: BROWN WYNDEMERE NORTH (410408) 2995 RIVERSIDE DR GREEN BAY WI 54301 (920) 337-9434 JULIE MONFORT County: BROWN GARLICKS CBRF INC (510020) 539 N EAU CLAIRE STREET MONDOVI WI 54755 (715) 926-5013 MARY JO LABAIR County: BUFFALO HILLVIEW SENIOR LIVING (0014061) 210 MEMORIAL DRIVE MONDOVI WI 54755 (715) 926-4962 KENNETH KING County: BUFFALO Association Approval: Leading Age HOMEPLACE OF MONDOVI (THE)-HAVEN (0011990) 158 E MAIN ST MONDOVI WI 54755 (715) 926-4778 DIANE MARUM County: BUFFALO ST MICHAELS ASSISTED LIVING (0014018) 270 NORTH STREET, PO BOX 7 FOUNTAIN CITY WI 54629 (608) 687-7721 PATRICIA STINSON County: BUFFALO COUNTRYSIDE ACRES ASSISTED LIVING, LLC (0013811) 5788 COUNTY ROAD C WEBSTER WI 54893 (715) 866-4411 SARA STADLER County: BURNETT

J & DEE INC (920) 337-9434 KERRY MONFORT 3001 RIVERSIDE DR GREEN BAY WI 54301 J & DEE INC (920) 337-9434 KERRY MONFORT 3001 RIVERSIDE DR GREEN BAY WI 54301 J & DEE INC (920) 337-9434 JULIE MONFORT 2995 RIVERSIDE DR GREEN BAY WI 54301 GARLICKS CBRF INC (715) 926-5013 MARY JO LABAIR W949 COUNTY ROAD A MONDOVI WI 54755 AMERICAN LUTHERAN HOMES, INC (715) 926-4962 KENNETH KING 210 MEMORIAL DRIVE MONDOVI WI 54755 JILL/JAMES TALLMAN (715) 644-2136 JASON HAZUGA 225 E 4TH AVE STANLEY WI 54768 ST. MICHAEL'S LUTHERAN HOME (608) 687-7721 PATRICIA STINSON 270 NORTH STREET, PO BOX 7 FOUNTAIN CITY WI 54629 SARA/THERESA STADLER/ROSSOW (715) 866-4411 SARA STADLER 5788 COUNTY ROAD C WEBSTER WI 54893

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 4,429/4,429 Initial License: 09/11/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,429/4,429 Initial License: 09/14/1992

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 6,634/6,785 Initial License: 03/16/1995

Type: Class:

CBRF CA Gender - Capacity: F - 5 Low/High rate: 3,803/3,803 Initial License: 06/01/1985

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,563/3,500 Initial License: 04/18/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 4,500/4,800 Initial License: 10/01/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 3,500/6,000 Initial License: 04/17/2012

Type: Class:

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 3,400/5,000 Initial License: 10/14/2011

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 10

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,323/2,573 Initial License: 04/04/2003

Type: Class:

SHADY KNOLL HOME (0010021) 240 W BROADWAY AVE GRANTSBURG WI 54840 (715) 463-5425 GREGORY PEER County: BURNETT BRILLION WEST HAVEN (0012537) 220 ACHIEVEMENT DR BRILLION WI 54110 (920) 756-9100 JACQUELINE LARDINOIS County: CALUMET CENTURY RIDGE INC (410508) 533 E CALUMET ST CHILTON WI 53014 (920) 849-2640 MARJORIE HARDRATH County: CALUMET CENTURY RIDGE INC (0008772) 531 E CALUMET ST CHILTON WI 53014 (920) 849-8529 DONNA KLOEHN County: CALUMET CENTURY RIDGE INC (0010623) 535 E CALUMET ST CHILTON WI 53014 (920) 849-2640 MARJORIE HARDRATH County: CALUMET COLONIAL RESIDENCE (0010143) 705 S MADISON ST CHILTON WI 53014 (920) 849-7171 ALICE BARTEL County: CALUMET GARDENS OF FOUNTAIN WAY (THE) (0010205) 1050 FOUNTAIN WAY MENASHA WI 54952 (920) 993-9980 CARLA FUS County: CALUMET Association Approval: WiCAL GARROW VILLA (410344) 210 S PARKWAY DR BRILLION WI 54110 (920) 756-3389 TRACY ROTH County: CALUMET LIBBYS HOUSE OF CHILTON (0013613) 323 FIELD LN CHILTON WI 53014 (920) 849-4657 CHRISTINE THILL County: CALUMET Association Approval: WALA OAK CREEK ASSISTED LIVING - KIEL (0012113) 1237 TEKLA PL KIEL WI 53042 (920) 894-3222 JUDY JOHNSON County: CALUMET ROADS TO FREEDOM BRILLION (0012211) 610 S MAIN ST BRILLION WI 54110 (920) 849-9351 MARTHA LEPPANEN County: CALUMET ROADS TO FREEDOM CHILTON (0012210) 1024 STEENPORT LN CHILTON WI 53014 (920) 849-9351 MARTHA LEPPANEN County: CALUMET

GSP OF GRANTSBURG INC (715) 463-2587 GREGORY PEER P O BOX 468 GRANTSBURG WI 54840 BRILLION SENIOR MANAGEMENT LLC (920) 337-2450 JACQULINE LARDINOIS 220 ACHIEVEMENT DR BRILLION WI 54110 CENTURY RIDGE INC (920) 468-2520 DAVID ZIMMERMAN 531 E CALUMET ST CHILTON WI 53014 CENTURY RIDGE INC (920) 849-8529 DAVID ZIMMERMAN 531 E CALUMET ST CHILTON WI 53014 CENTURY RIDGE INC (920) 468-2520 DAVID ZIMMERMAN 531 E CALUMET ST CHILTON WI 53014 BARTEL (920) 849-7171 ALICE BARTEL 705 S MADISON ST CHILTON WI 53014 GARDENS OF FOUNTAIN WAY LLC (920) 739-0111 CARLA FUS 1050 FOUNTAIN WAY MENASHA WI 54952 CITY OF BRILLION HOUSING AUTHORITY (920) 756-3041 TRACY ROTH 210 S PARKWAY DR BRILLION WI 54110 LIBBYS HOUSE OF CHILTON (920) 946-7327 CHRISTIN THILL 2653 VALLEY RD PLYMOUTH WI 53073 P & J OAKS LLC - KIEL (920) 973-0855 JUDY JOHNSON 1237 TEKLA PL KIEL WI 53042 NEW HOPE CENTER INC (920) 849-9351 MARTHA LEPPANEN PO BOX 189 CHILTON WI 53014 NEW HOPE CENTER INC (920) 849-9351 MARTHA LEPPANEN PO BOX 189 CHILTON WI 53014

ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 52 Low/High rate: 3,150/4,635 Initial License: 10/28/2008

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,450/3,000 Initial License: 10/23/1997

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,750/3,000 Initial License: 01/08/2000

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,750/3,000 Initial License: 07/08/2004

Type: Class:

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 2,000/2,000 Initial License: 06/12/2002

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 23 Low/High rate: 2,700/3,860 Initial License: 11/25/2003

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,879/3,384 Initial License: 03/01/1994 CBRF CNA M/F - 26 Low/High rate: 4,500/8,500 Initial License: 02/19/2011

Type: Class: Type: Class:

Gender - Capacity:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 2,550/4,300 Initial License: 11/09/2007 CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 4,463/4,463 Initial License: 01/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 3,716/3,716 Initial License: 01/01/2008

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 11

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 50 Low/High rate: 2,730/3,390 Initial License: 04/01/2006

Type: Class:

WILLOWPARK RESIDENCE (0011386) 1706 HOOVER ST NEW HOLSTEIN WI 53061 (920) 898-5553 BRITNEY DIERCKS County: CALUMET BROMEISL GROUP HOME (510009) 100 W GREENVILLE ST CHIPPEWA FALLS WI 54729 (715) 723-0459 JOHN BROMEISL County: CHIPPEWA BURPO CBRF (510291) 26101 275TH ST HOLCOMBE WI 54745 (715) 595-4644 RITA BURPO County: CHIPPEWA CARE PARTNERS ASSISTED LIVING BLOOMER II (001257 406 B PRIDDY STREET BLOOMER WI 54724 (715) 568-4009 ROBERTA DEMERS County: CHIPPEWA CHIPPEWA VALLEY GROUP HOME (0009211) 1022 FIRST AVENUE CHIPPEWA FALLS WI 54729 (715) 726-1820 AMANDA DUCE County: CHIPPEWA COMFORTS OF HOME-CHIPPEWA FALLS I (0009840) 11 SCHEIDLER ROAD CHIPPEWA FALLS WI 54729 (715) 720-8912 MICHELE BOWE County: CHIPPEWA COMFORTS OF HOME-CHIPPEWA FALLS II (0009839) 1212 PUMPHOUSE RD CHIPPEWA FALLS WI 54729 (715) 720-8912 MICHELE BOWE County: CHIPPEWA COUNTRY TERRACE - BLOOMER (0011080) 406 PRIDDY ST BLOOMER WI 54724 (715) 568-4009 ROBERTA DEMERS County: CHIPPEWA COUNTRY TERRACE - STANLEY (0012898) 804 PINE ST STANLEY WI 54768 (715) 644-3444 HAILEY SLOWIAK County: CHIPPEWA EAGLETON RESIDENCE (0011784) 14135-150TH AVE BLOOMER WI 54724-4410 (715) 288-6311 DEBORAH ASHLEY County: CHIPPEWA HAVEN OF STANLEY(THE) (0012212) 225 E 4TH AVE STANLEY WI 54768 (715) 644-2136 JASON HAZUGA County: CHIPPEWA

ALC OPERATING LLC (262) 257-8888 MARY T ZAK-KOWALCZYK W140N8981 LILLY RD MENOMONEE FALLS WI 53051-2325 JOHN BROMEISL (715) 723-0459 JOHN BROMEISL 100 W GREENVILLE ST CHIPPEWA FALLS WI 54729 (715) 595-4644 RITA BURPO 26101 275TH ST HOLCOMBE WI 54745-4506 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 AMANDA K DUCE (715) 726-1820 AMANDA DUCE 1022 FIRST AVENUE CHIPPEWA FALLS WI 54729 CHIPPEWA FALLS COH LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118 CHIPPEWA FALLS COH LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 COUNTRY TERRACE OF WISCONSIN LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 HEYDE HEALTH SYSTEM INC (715) 726-9094 MARTIN METTEN 345 FRENETTE DR CHIPPEWA FALLS WI 54729 JILL TALLMAN (715) 644-2136 JASON HAZUGA 225 E 4TH AVE STANLEY WI 54768

ADVANCED AGED

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,875/3,210 Initial License: 09/28/1983

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF AA Gender - Capacity: F - 7 Low/High rate: 1,402/1,402 Initial License: 06/15/1989

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,200/4,000 Initial License: 10/09/2008

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 1,621/3,972 Initial License: 01/19/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 3,000/3,800 Initial License: 09/01/2002

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/3,800 Initial License: 09/01/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,702/3,952 Initial License: 08/12/2005

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,400/4,200 Initial License: 08/01/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 2,950/4,875 Initial License: 08/10/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 4,500/4,700 Initial License: 05/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 12

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,782/3,782 Initial License: 11/01/2007

Type: Class:

NEW HOPE CBRF INC (0012152) 133 W ELM ST CHIPPEWA FALLS WI 54729 (715) 720-1551 JOHN SCHULTZ County: CHIPPEWA NEW HOPE HALLIE INC (0013009) 10875 40TH AVENUE CHIPPEWA FALLS WI 54729 (715) 720-7360 KAREN BLACK County: CHIPPEWA OUR HOUSE ASSISTED CARE (0013432) 115 MARRS ST CHIPPEWA FALLS WI 54729 (715) 723-6840 LORI NARDIN County: CHIPPEWA OUR HOUSE MEMORY CARE (0013435) 105 MARRS ST CHIPPEWA FALLS WI 54729 (715) 723-6037 KELSEY LIEN County: CHIPPEWA ROSE GARDEN ASSISTED LIVING FACILITY (0013503) 1840 PRIDDY ST BLOOMER WI 54724 (715) 568-2503 REBEKAH STREIT County: CHIPPEWA ROTH HOME SUITE HOME (0014044) 13362 - 98TH AVE CHIPPEWA FALLS WI 54729 (715) 726-1113 STEVE ROTH County: CHIPPEWA RUTLEDGE HOME (0011783) 300 BRIDGEWATER AVE CHIPPEWA FALLS WI 54729 (715) 723-5566 ALEXANDER PRICE County: CHIPPEWA Association Approval: WiCAL AURORA RES ALT CENTURY HOUSE 051 (510265) W5574 CENTURY ROAD GREENWOOD WI 54437 (715) 267-6607 JENNIFER SANDOR County: CLARK COHO LLC (0009438) 502 W ADAMS ST COLBY WI 54421 (715) 223-0150 JEFFREY FRESIA County: CLARK COUNTRY TERRACE ABBOTSFORD (0014129) 100 S 4TH AVE ABBOTSFORD WI 54405 (715) 223-2182 SHELLY BENDER County: CLARK HOMEPLACE OF DORCHESTER LLC - CBRF (0013040) 155 N 3RD ST DORCHESTER WI 54425 (715) 654-6009 JASON HAZUGA County: CLARK MEMORIAL MEDICAL CENTER SUNSET GARDENS (0013 216 SUNSET PLACE NEILLSVILLE WI 54456 (715) 743-3101 SCOTT POLENZ County: CLARK

JOHN C/TERESA R SCHULTZ (715) 382-5100 JOHN C/TERESA R SCHULTZ P.O. BOX 686 CHIPPEWA FALLS WI 54729-0686 NEW HOPE HALLIE INC (715) 720-7360 KAREN BLACK 2111 WHEATON STREET CHIPPEWA FALLS WI 54729 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 ROSE GARDEN ASSISTED LIVING FACILITY LLC (715) 568-2503 REBEKAH STREIT 1840 PRIDDY ST BLOOMER WI 54724 HOME SUITE HOME LLC (715) 382-3252 STEVE ROTH 24898 - 130TH AVE CADOTT WI 54727 WOLFTEVER HEALTHCARE LLC (715) 723-5566 CAROLYN VOLRATH 300 BRIDGEWATER AVE CHIPPEWA FALLS WI 54729 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 COHO LLC (715) 835-4111 JEFFREY FRESIA 1280 W CLAIREMONT AVE EAU CLAIRE WI 54701 COUNTRY TERRACE OF WI INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 HOMEPLACE OF DORCHESTER LLC (715) 644-2137 JASON HAZUGA 225 E 4TH AVE STANLEY WI 54768 MEMORIAL MEDICAL CENTER (715) 743-3101 SCOTT POLENZ 216 SUNSET PLACE NEILLSVILLE WI 54456

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,782/3,782 Initial License: 10/22/2009

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,300/3,400 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,730/3,830 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,335/3,665 Initial License: 12/13/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 2,500/4,200 Initial License: 03/01/2012

Type: Class:

ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 46 Low/High rate: 2,550/4,150 Initial License: 04/03/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 3,741/4,806 Initial License: 04/28/1994

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,500/4,500 Initial License: 10/01/2001

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,000/4,500 Initial License: 04/18/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 4,500/4,700 Initial License: 05/07/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,250/3,000 Initial License: 10/13/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 13

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,500 Initial License: 01/29/2007

Type: Class:

MILLER ALTERNATIVE CARE OF THORP LLC (0011755) 104 SODERBERG DR THORP WI 54771 (715) 669-7670 KATHY MILLER County: CLARK

DAVID MILLER (715) 352-2736 DAVID MILLER W782 LEROY ST EDGAR WI 54426

PABICHS RESIDENTIAL FACILITY INC (510067) 311 W HUNT ST GREENWOOD WI 54437 (715) 267-7410 ROBERTA PABICH County: CLARK WOODLAND CARE CBRF (0014104) W4266 STATE HWY 29 OWEN WI 54460 (715) 229-2172 JANE SCHMITZ County: CLARK Association Approval: Leading Age AMERICANWAY OF PORTAGE DEMENTIA SPECIALTY I (0 611 E ALBERT ST PORTAGE WI 53901 (608) 566-1500 STEPHANIE COOK County: COLUMBIA AMERICANWAY OF PORTAGE DEMENTIA SPECIALTY II ( 613 EAST ALBERT ST PORTAGE WI 53901 (608) 566-1500 STEPHANIE COOK County: COLUMBIA AMERICANWAY OF PORTAGE I (0011822) 601 LATTON LA PORTAGE WI 53901 (608) 742-0366 ANGIE DITTBERNER County: COLUMBIA Association Approval: AMERICANWAY OF PORTAGE II (0011823) 621 LATTON LA PORTAGE WI 53901 (608) 742-0366 NICOLE GRAZIANO County: COLUMBIA

PABICHS RESIDENTIAL FACILITY INC (715) 305-3210 ROBERTA PABICH 601 STEVEN AVENUE GREENWOOD WI 54437 CLARK COUNTY HEALTH CARE CENTER (715) 229-2172 ANGELA GRESCHNER W4266 STATE HWY 29 OWEN WI 54460 AMERICANWAY OF PORTAGE LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST SUITE 3 PORTAGE WI 53901 AMERICANWAY OF PORTAGE LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST SUITE 3 PORTAGE WI 53901 AMERICANWAY OF PORTAGE LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST STE 3 PORTAGE WI 53901 AMERICANWAY OF PORTAGE LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST STE 3 PORTAGE WI 53901

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,267/2,510 Initial License: 03/01/1980

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 6,200/9,300 Initial License: 05/25/2012

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 10 Low/High rate: 3,500/4,500 Initial License: 12/08/2008

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,500/4,500 Initial License: 12/08/2008 CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,900/3,750 Initial License: 07/01/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,600/3,700 Initial License: 04/09/2007

Type: Class:

Association Approval: AT HOME AGAIN COLUMBUS LLC (0013676) 110 STUART ST COLUMBUS WI 53925 (920) 623-9833 MELISSA OCONNOR County: COLUMBIA AT HOME AGAIN RIO (0013926) 405 LOWVILLE RD RIO WI 53960 (920) 992-6430 PATRICIA CONNERY County: COLUMBIA CBL INC DBA THE REMINGTON HOUSE (0008879) 113 INDUSTRIAL DR PARDEEVILLE WI 53954 (608) 429-4443 JEAN KOCH County: COLUMBIA

AHA COLUMBUS MANAGEMENT LLC (920) 623-9833 MELISSA OCONNOR 110 STUART ST COLUMBUS WI 53925 AT HOME AGAIN RIO LLC (920) 992-6430 PATRICIA CONNERY 405 LOWVILLE RD RIO WI 53960 CBL INC (608) 297-7012 JEAN KOCH 113 INDUSTRIAL DR PARDEEVILLE WI 53954

Gender - Capacity:

CBRF CNA M/F - 36 Low/High rate: 2,700/4,700 Initial License: 04/20/2011

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,000/3,500 Initial License: 11/09/2011 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,800/3,100 Initial License: 01/01/2000

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 14

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 3,000/4,500 Initial License: 05/04/2012

Type: Class:

COUNTRY TERRACE POYNETTE (0014136) 208 W NORTH ST POYNETTE WI 53955 (608) 635-4183 KELLEY BUELOW County: COLUMBIA LAKE PLACE GROUP HOME (110023) 105 LAKE RD PORTAGE WI 53901 (608) 742-4746 JULIE BRIGGS County: COLUMBIA LARSON HOUSE I (110452) 550 RIVER RD COLUMBUS WI 53925 (920) 623-5253 SUSAN HEWITT County: COLUMBIA LARSON HOUSE II (THE) (0009633) 550 RIVER RD COLUMBUS WI 53925 (920) 623-5253 SUSAN HEWITT County: COLUMBIA

COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 ARC OF COLUMBIA COUNTY (608) 742-0260 JULIE BRIGGS 711 E COOK ST PORTAGE WI 53901 LARSON HOUSE INC (920) 623-5253 SUSAN HEWITT 550 RIVER RD COLUMBUS WI 53925 SUSAN HEWITT (920) 623-5253 SUSAN HEWITT 550 RIVER RD COLUMBUS WI 53925

Gender - Capacity:

CBRF CS M/F - 8 Low/High rate: 2,112/2,112 Initial License: 01/01/1981

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,000/4,450 Initial License: 03/01/1995

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 3,200/3,800 Initial License: 06/01/2002

OUR HOUSE ASSISTED CARE (0013385) 1954 STATE RD 23 WISCONSIN DELLS WI 53965 (608) 253-3404 JONI SPAWN County: COLUMBIA OUR HOUSE ASSISTED CARE (0013382) 121 SECOND STREET LODI WI 53555 (608) 592-7433 ANGIE HILDEBRANT County: COLUMBIA OUR HOUSE MEMORY CARE (0013383) 1950 STATE ROAD 23 WISCONSIN DELLS WI 53965 (608) 253-7901 NIRA FISHER County: COLUMBIA OUR HOUSE SENIOR LIVING (0013665) 2876 VILLAGE DR PORTAGE WI 53901 (608) 745-0330 BECKY ANTIPOREK County: COLUMBIA RIDGES OF LODI (THE) (0013976) 215 DALE DRIVE LODI WI 53555-0308 (608) 592-0394 MARIA JOHNSON County: COLUMBIA TIVOLI AT DIVINE SAVIOR HEALTHCARE (0013388) 2805 HUNTERS TRAIL PORTAGE WI 53901 (608) 742-4131 JENNIFER BIENO County: COLUMBIA Association Approval: Leading Age BLUFF HAVEN ASSISTED LIVING (0012823) 720 S FREMONT ST PRAIRIE DU CHIEN WI 53821 (608) 326-8472 ALESHA ERDENBERGER County: CRAWFORD Association Approval: Leading Age

KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 THE RIDGES MEMORY CARE LLC (414) 526-4007 CLARENCE SOVA 1218 NORIDGE TRAIL PORT WASHINGTON WI 53074 DIVINE SAVIOR HEALTHCARE INC (608) 742-4131 JENNIFER BIENO 2805 HUNTERS TRAIL PORTAGE WI 53901 PRAIRIE MEMORIAL HOUSING LLC (608) 326-3200 ALESHA ERDENBERGER 720 S FREMONT ST PRAIRIE DU CHIEN WI 53821

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,100/3,150 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 2,800/3,050 Initial License: 09/30/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,300/3,350 Initial License: 09/30/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 18 Low/High rate: 2,950/4,950 Initial License: 04/15/2011

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,090/5,500 Initial License: 01/26/2012

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 3,850/5,100 Initial License: 12/27/2010 CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 2,990/4,090 Initial License: 08/10/2009

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 15

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 2,998/5,637 Initial License: 03/01/1980

Type: Class:

KNAPP HOME CASS STREET (110418) 216 W CASS ST PRAIRIE DU CHIEN WI 53821 (608) 326-2843 LYNN JENKINS County: CRAWFORD

LORI KNAPP CRAWFORD INC (608) 326-5536 KELLY GOCHENAUR 106 S BEAUMONT RD PRAIRIE DU CHIEN WI 53821

VILLA SUCCES (110410) 121 SOUTH PRAIRIE ST PRAIRIE DU CHIEN WI 53821 (608) 326-8424 LACIE ANTHONY County: CRAWFORD WALTER SCHMIDT ASSISTED LIVING (110413) 424 N BEAUMONT RD PRAIRIE DU CHIEN WI 53821 (608) 357-2170 SARA GHAN County: CRAWFORD ALL SAINTS ASSISTED LIVING AND MEMORY CARE (0012 8210 HIGHVIEW DRIVE MADISON WI 53719 (608) 827-2990 CARLA DURST County: DANE AMERICANWAY OF MADISON (0012791) 734 MESTA LANE MADISON WI 53704 (608) 246-0409 JANIS DEETS NOWAK County: DANE

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN M (608) 392-9582 BECKY WILSON-PODLENA 608 SOUTH 11TH ST LACROSSE WI 54601 PRAIRIE DU CHIEN MEMORIAL HOSPITAL (608) 357-2000 WILLIAM SEXTON 705 E TAYLOR ST PRAIRIE DU CHIEN WI 53821 ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY GRIFFIN 1402 PANKRATZ ST STE 110 MADISON WI 53704 AMERICANWAY OF MADISON LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST STE 3 PORTAGE WI 53901

Gender - Capacity:

CBRF AA M/F - 12 Low/High rate: 4,801/16,523 Initial License: 12/31/1981

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

Gender - Capacity:

CBRF CS M/F - 31 Low/High rate: 2,254/2,833 Initial License: 01/18/1988

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 58 Low/High rate: 4,650/5,340 Initial License: 07/16/2008

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,750/4,500 Initial License: 10/01/2009

ARC DAYTON ST (110328) 2009 E DAYTON ST MADISON WI 53704 (608) 241-7616 JAN BATTLE County: DANE ARC HOUSE (110002) 202 N PATERSON ST MADISON WI 53703 (608) 283-6430 CELESTA J MILLER County: DANE ARC MATERNAL & INFANT PROGRAM (110391) 4202 MONONA DR MADISON WI 53716 (608) 223-9033 MICHELLE RUSHTON County: DANE ARTISAN DEFOREST (THE) (0014425) 206 N MAIN ST DEFOREST WI 53532 (608) 846-6999 KERSTYN RASINS County: DANE ARTISAN MIDDLETON I (THE) (0014432) 5340 CENTURY AVE MIDDLETON WI 53562 (608) 833-6533 CINDY REED County: DANE ARTISAN MIDDLETON II (THE) (0014433) 5330 CENTURY AVE MIDDLETON WI 53562 (608) 833-6533 CINDY REED County: DANE

ARC COMMUNITY SERVICES INC (608) 278-2300 KAREN D KINSEY 2001 W BELTLINE HWY STE 102 MADISON WI 53713 ARC COMMUNITY SERVICES INC (608) 278-2300 JUDY BALDWIN 2001 W BELTLINE HWY STE 102 MADISON WI 53713 ARC COMMUNITY SERVICES INC (608) 278-2300 KAREN KINSEY 2001 W BELTLINE HWY STE 102 MADISON WI 53713 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713

CBRF AA Gender - Capacity: F - 12 Low/High rate: 2,540/3,046 Initial License: 01/15/1992

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: F - 15 Low/High rate: 2,740/2,740 Initial License: 03/31/1981

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: F - 12 Low/High rate: 2,473/2,769 Initial License: 02/01/1994

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,900/4,600 Initial License: 12/01/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 44 Low/High rate: 3,200/4,615 Initial License: 12/01/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 52 Low/High rate: 4,888/7,000 Initial License: 12/01/2012

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 16

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,500/5,000 Initial License: 01/08/2002

Type: Class:

ASHWABAY HOUSE (THE) (0009535) 7310 ASHWABAY LANE MADISON WI 53719 (608) 276-5883 RUTH POLACEK County: DANE

FOUNTAINHEAD HOMES (608) 441-7080 RUTH POLACEK PO BOX 46010 MADISON WI 53744

ATTIC ANGEL PLACE HAVEN (0012016) 8301 OLD SAUK RD MIDDLETON WI 53562 (608) 662-8842 JENNIFER GRAVES County: DANE Association Approval: Leading Age ATTIC CORRECTIONAL TREATMENT CENTER (110047) 4117 DWIGHT DR MADISON WI 53704 (608) 244-1891 VICKI TREBIAN County: DANE AUTUMN LIGHT HOME (0009413) 1003 TAMARACK WAY VERONA WI 53593 (608) 848-1366 JINLAN LIU County: DANE AVALON ASSISTED LIVING COMMUNITY 500 (0011914) 2879 FISH HATCHERY RD MADISON WI 53713 (608) 270-6095 SHIRLY KELLER County: DANE AVALON ASSISTED LIVING COMMUNITY 600 (0011927) 2879 FISH HATCHERY RD MADISON WI 53713 (608) 270-6091 SHIRLY KELLER County: DANE AVALON ASSISTED LIVING COMMUNITY 700 (0011915) 2879 FISH HATCHERY RD MADISON WI 53713 (608) 270-6097 SHIRLY KELLER County: DANE BAYSIDE CARE CENTER (0013603) 702 W MAIN ST MADISON WI 53703 (608) 280-2700 HANNAH FLANAGAN County: DANE BRIGHTER LIFE LIVING (0011577) 901 PFLAUM RD MADISON WI 53716 (608) 712-4962 JASON STANDISH County: DANE

ATTIC ANGEL PLACE INC (608) 662-8842 JENNIFER GRAVES 8301 OLD SAUK RD MIDDLETON WI 53562 ATTIC CORRECTIONAL SERVICES INC (608) 223-0017 LESLEY JOHNSON 601 ATLAS AVE PO BOX 7370 MADISON WI 53707 AUTUMN LIGHT HOME (608) 848-1366 JENNIFER ZHAO 1003 TAMARACK WAY VERONA WI 53593 MADISON ASSISTED LIVING LLC (541) 686-1119 SHIRLY KELLER 2879 FISH HATCHERY RD MADISON WI 53713 MADISON ASSISTED LIVING LLC (541) 686-1119 SHIRLY KELLER 2879 FISH HATCHERY RD MADISON WI 53713 MADISON ASSISTED LIVING LLC (541) 686-1119 SHIRLY KELLER 2879 FISH HATCHERY RD MADISON WI 53713 JOURNEY MENTAL HEALTH CENTER (608) 280-2700 LYNN BRADY 625 W WASHINGTON AVE MADISON WI 53703 JASON STANDISH (608) 712-4962 JASON STANDISH 924 EAST MIFFLIN ST MADISON WI 53703

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 6,820/6,820 Initial License: 09/11/2007

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 19 Low/High rate: 2,280/2,280 Initial License: 12/01/1979

Type: Class:

CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,200/4,500 Initial License: 10/18/2001

Type: Class:

ADVANCED AGED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 11 Low/High rate: 2,795/4,495 Initial License: 05/22/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 11 Low/High rate: 2,595/4,495 Initial License: 04/17/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 23 Low/High rate: 2,595/4,495 Initial License: 05/22/2007

Type: Class:

Gender - Capacity:

CBRF CS M/F - 12 Low/High rate: 9,240/13,500 Initial License: 02/23/2011

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,800/5,000 Initial License: 07/31/2006

Type: Class:

CAMPBELL HOUSE (110505) 7197 LOPER RD SAUK CITY WI 53583 (608) 643-3113 GRETCHEN CAMPBELL County: DANE CAPITOL LAKES TERRACES (110509) 345 W MAIN ST MADISON WI 53703 (608) 283-2083 BONNIE BANKER County: DANE Association Approval: Leading Age

GRETCHEN AND GERALD CAMPBELL (608) 643-3113 GRETCHEN CAMPBELL 7197 LOPER RD SAUK CITY WI 53583 CAPITOL LAKES INC (608) 283-2083 BONNIE BANKER 345 WEST MAIN ST MADISON WI 53703

CBRF CA Gender - Capacity: M - 6 Low/High rate: 3,710/6,000 Initial License: 11/01/1991

Type: Class:

CBRF CNA Gender - Capacity: M/F - 48 Low/High rate: 5,296/6,582 Initial License: 04/01/1996

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 17

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,900/3,400 Initial License: 12/18/1998

Type: Class:

CHAMOMILE ASSISTED LIVING LTD (0008514) 22 MILO LANE MADISON WI 53714 (608) 241-3431 JEFF SHIELDS County: DANE CHAMOMILE ASSISTED LIVING LTD II (0010867) 842 JUPITER DR MADISON WI 53718 (608) 819-0221 JEFF SHIELDS County: DANE CLARE BRIDGE OF MIDDLETON (110304) 6701 STONEFIELD RD MIDDLETON WI 53562 (608) 831-2707 KATHY KEENA County: DANE CLARE BRIDGE OF SUN PRAIRIE (110491) 650 BROADWAY DR SUN PRAIRIE WI 53590 (608) 825-9300 ROBERT GORE County: DANE COVENANT OAKS (0008572) 6165 MINERAL POINT RD MADISON WI 53705 (608) 230-4311 MICHELLE GODFREY County: DANE Association Approval: Leading Age CREEKWOOD CBRF (0008584) 200 CROSS ST WAUNAKEE WI 53597 (608) 849-7395 SHARON MULLINS County: DANE DEERFIELD PLACE ASSISTED LIVING (0014236) 15 STATE ST DEERFIELD WI 53531 (608) 764-3142 MEGAN NACHREINER County: DANE EMERITUS AT LEGACY GARDENS (0013336) 1601 WHEELER RD MADISON WI 53704 (608) 249-5558 LISA FORD County: DANE FAITH LIVING CENTER (0013790) 131 CLARMAR DR SUN PRAIRIE WI 53590 (608) 825-3178 RACHEL BAEHR County: DANE FOSTER COMMUNITY CORRECTIONS CENTER (110377) 5706 ODANA RD MADISON WI 53719 (608) 273-3055 VICKI TREBIAN County: DANE FOUNTAINHEAD HOMES (0009770) 5222 HAMMERSLEY RD MADISON WI 53711 (608) 274-4642 RUTH POLACEK County: DANE

CHAMOMILE ASSISTED LIVING LTD (608) 819-0221 JEFF SHIELDS 2724 THINNES STREET CROSS PLAINS WI 53528 JEFF SHIELDS (608) 798-4523 JEFF SHIELDS 2722 THINNES ST CROSS PLAINS WI 53528 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 KATHY KEENA 6701 STONEFIELD RD MIDDLETON WI 53562 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 ROBERT GORE 650 BROADWAY DR SUN PRAIRIE WI 53590 OAKWOOD LUTHERAN HOMES INC (608) 230-4311 KATHY GROTH 6165 MINERAL POINT RD MADISON WI 53705 CREEKWOOD ASSISTED LIVING LLC (608) 222-3757 DONALD LANGE 714 WOODWARD DR MADISON WI 53704 GEROU-NACHREINER PROPERTIES LLC (262) 361-2149 MEGAN NACHREINER W1432 VALLEY VIEW COURT IXONIA WI 53036 EMERITUS CORP DBA EMERITUS CORP OF WA (206) 298-2909 LISA FORD 1601 WHEELER RD MADISON WI 53704 FAITH LIVING CENTER (608) 712-4663 RACHEL BAEHR 131 CLARMAR DR SUN PRAIRIE WI 53590 ATTIC CORRECTIONAL SERVICES INC (608) 223-0017 LESLEY JOHNSON PO BOX 7370 MADISON WI 53707-7370 FOUNTAINHEAD HOMES (608) 441-7080 JOSEPH POLACEK PO BOX 46010 MADISON WI 53744-6010

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 2,700/3,300 Initial License: 06/15/2005

Type: Class:

ADVANCED AGED PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 3,367/8,005 Initial License: 04/28/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,795/5,033 Initial License: 11/25/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 6,570/6,810 Initial License: 11/01/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,350/3,900 Initial License: 04/22/1999

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 9 Low/High rate: 3,500/4,100 Initial License: 08/01/2012

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 73 Low/High rate: 2,345/3,975 Initial License: 08/05/2010 CBRF CNA Gender - Capacity: M/F - 21 Low/High rate: 3,375/4,975 Initial License: 09/06/2011

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M - 18 Low/High rate: 2,160/2,160 Initial License: 09/01/1993

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,000/4,800 Initial License: 02/01/2003

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 18

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,300/5,200 Initial License: 06/04/2008

Type: Class:

FOUNTAINHEAD HOMES THE RAYMOND HOUSE (001229 825 SOUTHBOUND DR DEFOREST WI 53532 (608) 842-0406 RUTH POLACEK County: DANE

FOUNTAINHEAD GROUP LLC (608) 347-0366 RUTH POLACEK PO BOX 46010 MADISON WI 53744

FOUR WINDS LODGE (110368) 309 SCHWEITZER DRIVE VERONA WI 53593 (608) 845-6465 LYNN HOWARD County: DANE GIRLIES MANOR (0010746) 104 LINCOLN CRT MOUNT HOREB WI 53572 (608) 437-2778 LANCE STEIN County: DANE GIRLIES MANOR III (0008704) 2620 MILITARY RD CROSS PLAINS WI 53528 (608) 798-1086 LANCE STEIN County: DANE GOODWILL JAMESTOWN GROUP HOME (110243) 5815 WILLIAMSBURG WAY MADISON WI 53719 (608) 271-1036 ELENA GOLDEN County: DANE HAACKS TENDERCARE (0010588) 1249 SCHOOL ST SUN PRAIRIE WI 53590 (608) 834-1706 JAMIEANN HAACK BRAATZ County: DANE HANNAHS HOUSE (0012865) 510 N GAMMON RD MADISON WI 53717 (608) 833-8679 JENNIFER EKLOF County: DANE

FOUR WINDS LODGE (608) 845-7971 LYNN HOWARD 309 SCHWEITZER DRIVE VERONA WI 53593 SENIOR CONCEPTS INC (608) 798-1086 DOUGLAS GREGORY 2620 MILITARY RD CROSS PLAINS WI 53528 SENIOR CONCEPTS INC (608) 798-1086 LANCE STEIN 2620 MILITARY RD CROSS PLAINS WI 53528 GOODWILL INDUSTRIES OF SC WIS INC (608) 246-3140 ELENA GOLDEN 1302 MENDOTA ST MADISON WI 53714 HAACKS TENDERCARE INC (608) 834-1706 JAMIEANN HAACK BRAATZ 1249 SCHOOL ST SUN PRAIRIE WI 53590 HANNAHS HOUSE LLC (608) 334-2116 JENNIFER EKLOF 5718 BELLOWS CR MADISON WI 53716

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,468/4,106 Initial License: 05/24/1993

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,750/3,800 Initial License: 11/01/2004

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,500/5,000 Initial License: 08/09/1999

Type: Class:

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 3,270/3,270 Initial License: 12/26/1988

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,350/5,150 Initial License: 05/17/2004

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,700/5,000 Initial License: 08/18/2009

Type: Class:

HANNAHS HOUSE EAST (0013459) 4702 MILWAUKEE ST MADISON WI 53714 (608) 249-4844 JENNIFER EKLOF County: DANE

HANNAHS HOUSE LLC (608) 334-2119 JENNIFER EKLOF 5718 BELLOWS CIRCLE MADISON WI 53716

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,500 Initial License: 10/01/2010

Type: Class:

HARBOR HOUSE STOUGHTON (0013404) 1221 E MAIN ST STOUGHTON WI 53589 (608) 873-8333 EMILY D'ANGELO County: DANE HARMONY OF MADISON (0008676) 705 ZIEGLER RD MADISON WI 53714 (608) 244-8863 MELISSA MILLER County: DANE Association Approval: WiCAL

AZURA STOUGHTON LLC (608) 873-8333 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051

CBRF CNA Gender - Capacity: M/F - 27 Low/High rate: 3,500/6,900 Initial License: 08/15/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 47 Low/High rate: 2,650/3,870 Initial License: 07/01/1999

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 19

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 2,310/4,100 Initial License: 05/01/2000

Type: Class:

HARMONY OF MCFARLAND (0009003) 5206 PAULSON CRT MCFARLAND WI 53558 (608) 838-2231 DOUG ZIEGAHN County: DANE Association Approval: WiCAL HARMONY OF STOUGHTON (0008677) 2321 JACKSON ST STOUGHTON WI 53589 (608) 877-1227 HELEN LARAE GAVIC County: DANE HARMONY OF SUN PRAIRIE (0008678) 35 TOWER DR SUN PRAIRIE WI 53590 (608) 825-6484 ROXANNE STAHNKE County: DANE Association Approval: WiCAL HERITAGE CENTER (111086) 400 NORTH MORRIS ST STOUGHTON WI 53589 (608) 873-5651 KRISTIAN KRENTZ County: DANE Association Approval: Leading Age HERITAGE COURT MIDDLETON (0014200) 6234 MAYWOOD AVE MIDDLETON WI 53562 (608) 831-7004 LARAE GAVIC County: DANE HERITAGE MONONA CBRF (0012891) 111 OWEN RD MONONA WI 53716 (608) 441-2400 KATHY LINDEN County: DANE HERITAGE OF MONONA FE HERITAGE 10 LLC (0014203) 111 OWEN RD MONONA WI 53716 (608) 441-9990 KATHY LINDEN County: DANE HERITAGE OF MONONA MC HERITAGE 10 LLC (0014202) 111 OWEN RD MONONA WI 53716 (608) 441-9990 KATHY LINDEN County: DANE HOMESTEAD LIVING INC (0012266) 1040 QUINN DR WAUNAKEE WI 53597 (608) 850-4610 LORI SAMOLYK County: DANE HOMETOWN ASSISTED LIVING INC (0013853) 2 HERITAGE LANE BELLEVILLE WI 53508 (608) 424-0174 MARGARET WILSON County: DANE HOPE HAVEN COLVIN MANOR (110013) 425 W JOHNSON ST MADISON WI 53703 (608) 441-3240 BRUCE NICHOLAS County: DANE

HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE K THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 SKAALEN RETIREMENT SERVICES INC (608) 873-5651 KRISTIAN KRENTZ 400 NORTH MORRIS ST STOUGHTON WI 53589 HERITAGE 11 LLC (952) 351-4541 CINDY REED 7901 W NATIONAL AVE WEST ALLIS WI 53214 MSP REAL ESTATE (952) 351-4542 KIM LANE 3585 S 147TH ST NEW BERLIN WI 53151 HERITAGE 10 LLC (952) 351-4541 KIM LANE 7901 W NATIONAL AVE WEST ALLIS WI 53214 HERITAGE 10 LLC (952) 351-4541 KIM LANE 7901 W NATIONAL AVE WEST ALLIS WI 53214 HOMESTEAD LIVING INC (612) 695-4906 CHAD ARMBRUSTER 1040 QUINN DRIVE WAUNAKEE WI 53597 HOMETOWN ASSISTED LIVING INC (608) 574-6337 LISA KLEIN 2 HERITAGE LANE BELLEVILLE WI 53508 HOPE HAVEN REBOS UNITED INC (608) 821-3100 MUSIC-ENGELS MELODY 425 W JOHNSON ST MADISON WI 53703

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 45 Low/High rate: 2,650/3,870 Initial License: 07/01/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,495/3,675 Initial License: 01/01/2000

Type: Class:

CBRF CNA Gender - Capacity: M/F - 50 Low/High rate: 4,044/5,038 Initial License: 07/31/1998

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 4,750/5,800 Initial License: 01/02/2013

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 39 Low/High rate: 3,600/5,800 Initial License: 11/24/2009

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 34 Low/High rate: 3,600/4,800 Initial License: 11/08/2012

Type: Class:

ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 41 Low/High rate: 4,300/5,300 Initial License: 11/08/2012

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,662/5,040 Initial License: 12/30/2008

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,100/4,400 Initial License: 09/23/2011

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 40 Low/High rate: 300/2,400 Initial License: 03/31/1982

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 20

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,775/4,500 Initial License: 01/31/2007

Type: Class:

KINDREDHEARTS OF COTTAGE GROVE (0011775) 325 W COTTAGE GROVE RD COTTAGE GROVE WI 53527 (608) 839-1555 STEPHANIE SOLBERG County: DANE KINDREDHEARTS OF COTTAGE GROVE (0011776) 505 W LAWN DR COTTAGE GROVE WI 53527 (608) 839-5343 STEPHANIE SOLBERG County: DANE MAHER HOME (THE) (0013573) 5225 MAHER AVE MADISON WI 53716 (608) 712-4962 JASON STANDISH County: DANE

PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 STEPHANIE SOLBERG 325 W COTTAGE GROVE RD COTTAGE GROVE WI 53527 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 STEPHANIE SOLBERG 505 WEST LAWN DR COTTAGE GROVE WI 53527 BRIGHTER LIFE LIVING LLC (608) 712-4962 JASON STANDISH 924 E MIFFLIN ST MADISON WI 53703

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,150/3,750 Initial License: 01/31/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,800/5,000 Initial License: 11/28/2011

Type: Class:

MAIN STREET QUARTERS (110279) 354 N MAIN ST OREGON WI 53575 (608) 835-3535 TOM GRAVES County: DANE MARIANNES ELDER HOUSE INC (110170) 6229 RENEE CT MCFARLAND WI 53558 (608) 838-9524 MARI LYNN STASSI County: DANE

MAIN STREET QUARTERS (608) 835-3535 THOMAS GRAVES 354 N MAIN ST OREGON WI 53575 MARIANNES ELDER HOUSE INC (608) 838-9524 MARI LYNN STASSI 6229 RENEE CT MCFARLAND WI 53558

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,709/3,759 Initial License: 04/01/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 2,400/3,600 Initial License: 07/31/1994

Type: Class:

NORTH BAY LODGE (110102) 3602 MEMORIAL DR MADISON WI 53704 (608) 249-2600 BRUCE NICHOLAS County: DANE NORTHPORT GROUP HOME (110130) 1602 NORTHPORT DR MADISON WI 53704 (608) 663-4552 ELENA GOLDEN County: DANE OAK PARK PLACE AUTUMN LANE (0011449) 702 JUPITER DR MADISON WI 53718 (608) 663-8600 KRISTIN DUNLAP County: DANE OAK PARK PLACE AUTUMN LANE II (0012511) 719 JUPITER DR MADISON WI 53718 (608) 663-8600 TONI CARRUTHERS County: DANE OAKWOOD KNOLL (0009395) 5565 TANCHO DR MADISON WI 53718 (608) 230-4538 JEAN JACOBSON County: DANE Association Approval: Leading Age OAKWOOD MEADOWS (0011119) 5565 TANCHO DR MADISON WI 53718 (608) 230-4538 JEAN JACOBSON County: DANE Association Approval: Leading Age

HOPE HAVEN REBOS UNITED INC (608) 821-3100 BRUCE NICHOLAS 3602 MEMORIAL DR MADISON WI 53704 GOODWILL INDUSTRIES OF MADISON (608) 246-3140 ELENA GOLDEN 1302 MENDOTA ST MADISON WI 53714 OAK PARK PLACE OF MADISON LLC (608) 663-8600 TONI CARRUTHERS 719 JUPITER DR MADISON WI 53718 OAK PARK PLACE OF MADISON LLC (608) 663-8600 TONI CARRUTHERS 719 JUPITER DR MADISON WI 53718 OAKWOOD VILLAGE E LUTH HOMES INC (608) 230-4538 DEBRA PITSCH 5565 TANCHO DR MADISON WI 53718 OAKWOOD VILLAGE EAST (608) 230-4538 DEBRA PITSCH 5565 TANCHO DR MADISON WI 53718

Gender - Capacity:

CBRF AA M/F - 20 Low/High rate: 325/2,100 Initial License: 02/01/1980

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,620/3,620 Initial License: 12/31/1981

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 36 Low/High rate: 4,150/4,800 Initial License: 06/01/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 27 Low/High rate: 4,275/5,700 Initial License: 11/19/2008

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 5,700/6,076 Initial License: 09/25/2001

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 6,210/6,510 Initial License: 04/01/2006

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 21

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,650/4,805 Initial License: 09/26/2001

Type: Class:

OAKWOOD SEASONS (0009394) 5565 TANCHO DR MADISON WI 53718 (608) 230-4538 JEAN JACOBSON County: DANE Association Approval: Leading Age OAKWOOD VILLAGE TABOR OAKS (110198) 6175 MINERAL POINT RD MADISON WI 53705 (608) 230-4699 MICHELLE GODFREY County: DANE Association Approval: Leading Age OFFSHORE GROUP HOME (110075) 6418 OFFSHORE DR MADISON WI 53705 (608) 238-9064 ELENA GOLDEN County: DANE ORCHID HOME OF VERONA INC (0013281) 1013 GATEWAY PASS VERONA WI 53593 (608) 848-9619 LOPAO VANG County: DANE OUR HOUSE ASSISTED CARE (0013377) 201 W MADISON ST CAMBRIDGE WI 53523 (608) 423-9961 TRISH STRAIT County: DANE PINE VIEW OF MADISON (0011309) 8410 BLACKWOLF DR MADISON WI 53517 (608) 833-4813 FRED BOYD County: DANE

OAKWOOD VILLAGE EAST LUTHERAN HOMES I (608) 230-4538 DEBRA PITSCH 5565 TANCHO DR MADISON WI 53718 OAKWOOD VILLAGE APARTMENTS INC (608) 230-4257 KATHY GROTH 6175 MINERAL POINT RD MADISON WI 53705 GOODWILL INDUSTRIES SOUTH CENTRAL WIS (608) 246-3140 ELENA GOLDEN 1302 MENDOTA ST MADISON WI 53714 ORCHID HOMES OF VERONA INC (608) 834-1694 LOPAO VANG 2914 VANG RD SUN PRAIRIE WI 53590 KSMS OUR HOUSE LLC (317) 280-8455 KWITEK KAREN 350 S. 85TH ST WAUSAU WI 54403 PINE VIEW LIVING INC (414) 466-2257 FRED BOYD 4525 NORTH 76TH ST MILWAUKEE WI 53218

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 5,490/5,490 Initial License: 07/01/1992

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,071/3,071 Initial License: 06/01/1983

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,000/4,500 Initial License: 04/06/2010

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,160/3,260 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 4,000/4,450 Initial License: 05/01/2006

Type: Class:

PINE VIEW OF SUN PRAIRIE (0011310) 605 WOOD VIOLET LANE SUN PRAIRIE WI 53590 (608) 837-6018 FRED BOYD County: DANE PINE VIEW OF WINDSOR (0011311) 6797 VALIANT DR WINDSOR WI 53598 (608) 846-9316 FRED BOYD County: DANE PORCHLIGHT (110310) 902 NORTHPORT DR MADISON WI 53704 (608) 242-6288 PAT SARTORI WHARTON County: DANE PRAIRIE GARDENS (0010589) 900 OKEEFFE AVE SUN PRAIRIE WI 53590 (608) 825-4884 SUZANNE HARBORT County: DANE REBOS CHRIS FARLEY HOUSE (110151) 810 W OLIN AVE MADISON WI 53715 (608) 255-5922 BRUCE NICHOLAS County: DANE

PINE VIEW LIVING INC (414) 466-2257 FRED BOYD 4525 NORTH 76TH ST MILWAUKEE WI 53218 PINE VIEW LIVING INC (414) 466-2257 FRED BOYD 4525 NORTH 76TH ST MILWAUKEE WI 53218 PORCHLIGHT INC (608) 257-2534 KARLA JAMESON 306 N BROOKS ST MADISON WI 53715 JERRY AND SUZANNE HARBORT (608) 837-0401 JERRY & SUZANNE HARBORT 1850 CORINTH DR SUN PRAIRIE WI 53590 HOPE HAVEN REBOS UNITED INC (608) 821-3100 BRUCE NICHOLAS 810 WEST OLIN AVE MADISON WI 53715

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,000/4,450 Initial License: 05/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,328/4,450 Initial License: 04/27/2006

Type: Class:

CBRF AA Gender - Capacity: M - 6 Low/High rate: 0/0 Initial License: 06/10/1991

Type: Class:

CBRF CNA Gender - Capacity: M/F - 53 Low/High rate: 3,200/3,800 Initial License: 05/12/2004

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 15 Low/High rate: 325/2,100 Initial License: 03/01/1989

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 22

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 1,800/3,100 Initial License: 05/01/2000

Type: Class:

REST HAVEN HEALTH CARE CENTER LLC (0009018) 7672 WEST MINERAL POINT RD VERONA WI 53593 (608) 833-1691 JEFFREY KRUCHTEN County: DANE REYNOLDS ASSISTED LIVING (0011746) 5318 SCHLUTER RD MONONA WI 53716 (608) 222-7557 TATE A REYNOLDS County: DANE SCHWERT AODA TREATMENT CENTER (110289) 3501 KIPLING DR MADISON WI 53704 (608) 249-6226 VICKI TREBIAN County: DANE SEBRING ASSISTED CARE RESIDENCE (0009868) 7710 SOUTH BROOKLINE DRIVE MADISON WI 53719 (608) 662-7622 BRUCE BECKMAN County: DANE SEGOE GARDENS ASSISTED LIVING (0009246) 606 NORTH SEGOE RD MADISON WI 53705 (608) 204-0904 JOAN (JESI) HIRSCH County: DANE SERENITY HOMES I (0011760) 504 BASSETT ST DEFOREST WI 53532 (608) 846-8610 BETHANY FIRKUS County: DANE SERENITY HOMES II (0011761) 506 BASSETT ST DEFOREST WI 53532 (608) 846-8610 TERRI WERNER County: DANE SERENITY HOMES STOUGHTON (0014193) 1940 JACKSON ST STOUGHTON WI 53589 (608) 873-1328 TERRI WERNER County: DANE SIENNA CREST MARSHALL (111052) 604 LEWELLEN STREET MARSHALL WI 53559 (608) 655-3507 SUSAN WHITE County: DANE SIENNA CREST OREGON (111073) 981 PARK STREET OREGON WI 53575 (608) 835-7781 SUE WHITE County: DANE SIENNA MEADOWS OF OREGON (0009869) 989 PARK ST OREGON WI 53575 (608) 835-0000 SUSAN WHITE County: DANE SO CLOSE TO HOME (0012837) 202 LAKEWOOD TERR MARSHALL WI 53559 (608) 655-8008 LINDA JANSEN County: DANE

REST HAVEN LLC (608) 833-1691 JEFFREY KRUCHTEN 7672 WEST MINERAL POINT RD VERONA WI 53593 TATE A REYNOLDS (608) 770-6351 TATE A REYNOLDS 6289 PORTAGE RD DEFOREST WI 53532 ATTIC CORRECTIONAL SERVICES INC (608) 223-0017 TODD M VEITH 5706 ODANA RD 1ST FLOOR MADISON WI 53719 COVENTRY VILLAGE OF WI LIMITED PARTNER (847) 996-0600 HARRIS F WEBBER 708 FLORSHEIM DR STE 10 LIBERTYVILLE IL 60048 INDEPENDENT LIVING INC (608) 274-7900 RITA GIOVANNONI 2970 CHAPEL VALLEY RD STE 203 MADISON WI 53711 EDGEWOOD ACRES ASSISTED LIVING LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT # 5 MADISON WI 53713-0000 EDGEWOOD ACRES ASSISTED LIVING LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT # 5 MADISON WI 53713-0000 SERENITY HOMES STOUGHTON LLC (608) 286-1231 WILLIAM/CHERYL TESNOW 1130 ALRITA CT #5 MADISON WI 53713 SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUSAN WHITE PO BOX 45 OREGON WI 53575 SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUE WHITE PO BOX 45 OREGON WI 53575 SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUSAN WHITE PO BOX 45 OREGON WI 53575 SO CLOSE TO HOME LLC (608) 206-2720 LINDA JANSEN 980 BRUCE ST SUN PRAIRIE WI 53590

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 3,500/5,500 Initial License: 02/05/2007

Type: Class:

CBRF ANA Gender - Capacity: M - 15 Low/High rate: 37,194/38,994 Initial License: 09/18/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 81 Low/High rate: 4,590/6,600 Initial License: 02/23/2004

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,100/4,100 Initial License: 03/05/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,200/4,500 Initial License: 01/01/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 3,200/4,500 Initial License: 01/01/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,600/4,600 Initial License: 06/01/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,975/3,775 Initial License: 01/31/1998

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,100/4,600 Initial License: 09/25/1998

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/5,700 Initial License: 12/09/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 9 Low/High rate: 3,000/4,500 Initial License: 08/12/2009

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 23

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,293/6,912 Initial License: 11/07/1997

Type: Class:

STERLING HOUSE OF MIDDLETON (111027) 6916 CENTURY AVE MIDDLETON WI 53562 (608) 827-8777 PATTY HENNEMAN County: DANE SUN PRAIRIE RETIREMENT CENTER (110453) 228 WEST MAIN ST SUN PRAIRIE WI 53590 (608) 837-5959 LARS ROGEBERG County: DANE SYLVAN CROSSINGS AT CHAPEL VALLEY (0008561) 5765 CHAPEL VALLEY RD FITCHBURG WI 53711 (608) 277-7586 PATRICK SENZIG County: DANE SYLVAN CROSSINGS IN WESTSHIRE VILLAGE (0010729) 5475 WESTSHIRE CIRCLE WAUNAKEE WI 53597 (608) 241-9872 ANGELA GREGER County: DANE SYLVAN CROSSINGS OF FITCHBURG (110524) 5784 CHAPEL VALLEY RD FITCHBURG WI 53711 (608) 274-1111 PATRICK SENZIG County: DANE TELLURIAN UCAN ACEWOOD HOUSE (110326) 221 ACEWOOD BLVD MADISON WI 53714 (608) 244-1359 GARY MIDTHUN County: DANE TELLURIAN UCAN ADULT RESIDENTIAL SERVICES (1105 300 FEMRITE DR MONONA WI 53716 (608) 222-7311 MARGARET BENSON County: DANE TELLURIAN UCAN CRAWFORD HOUSE (110366) 4326 CRAWFORD DR MADISON WI 53711 (608) 277-8768 GARY MIDTHUN County: DANE TELLURIAN UCAN TRANSITIONAL HOUSING (0009432) 300 FEMRITE DR MADISON WI 53716 (608) 222-7311 RICHARD SCHWICHTENBERG County: DANE TIMBERWOOD HOMES (0010792) 7102 TIMBERWOOD DR MADISON WI 53719 (608) 848-8668 MARY KAY FIELDS County: DANE TRINITY SENIOR COMMUNITY 5555 (0013815) 5555 BURKE RD MADISON WI 53718 (608) 245-1198 DAMON FREI County: DANE

BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 PATTY HENNEMAN 6916 CENTURY AVE MIDDLETON WI 53562 EDWIN KRUCHTEN (608) 849-5016 LARS ROGEBERG 228 WEST MAIN ST SUN PRAIRIE WI 53590 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 TELLURIAN UCAN INC (608) 712-3564 GARY MIDTHUN 300 FEMRITE DR MONONA WI 53716 TELLURIAN UCAN INC (608) 222-7311 MARGARET BENSON 300 FEMRITE DR MONONA WI 53716 TELLURIAN UCAN INC (608) 712-3564 GARY MIDTHUN 300 FEMRITE DR MONONA WI 53716 TELLURIAN UCAN INC (608) 222-7311 TIM OLSEN 300 FEMRITE DRIVE MADISON WI 53716 PLEIADES AND THE ALDEBARAN LLC (608) 848-8668 MARY KAY FIELDS 3013 FOXWOOD TRAIL MADISON WI 53713 TRINITY SENIOR COMMUNITY II LLC (847) 692-1152 BENJAMIN ISRAEL 6400 SHAFER CT #700 ROSEMONT IL 60018

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED

CBRF AS Gender - Capacity: M/F - 7 Low/High rate: 1,800/2,500 Initial License: 07/31/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,210/4,460 Initial License: 03/01/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 34 Low/High rate: 3,500/4,860 Initial License: 12/06/2004

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 19 Low/High rate: 5,100/5,925 Initial License: 09/01/1996

Type: Class:

Gender - Capacity:

CBRF AA M/F - 7 Low/High rate: 3,597/3,597 Initial License: 12/13/1991

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 38 Low/High rate: 25/5,670 Initial License: 08/05/1996

Type: Class:

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Gender - Capacity:

CBRF AS M/F - 7 Low/High rate: 4,208/4,208 Initial License: 04/26/1993

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 280/2,973 Initial License: 03/15/2002

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M - 8 Low/High rate: 2,500/5,500 Initial License: 12/02/2004 CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,105/5,035 Initial License: 10/07/2011

Type: Class:

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

Association Approval: WALA

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 24

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,105/5,035 Initial License: 10/07/2011

Type: Class:

TRINITY SENIOR COMMUNITY 5565 (0013816) 5565 BURKE RD MADISON WI 53718 (608) 245-1198 DAMON FREI County: DANE

TRINITY SENIOR COMMUNITY II LLC (847) 692-1152 BENJAMIN ISRAEL 6400 SHAFER CT #700 ROSEMONT IL 60018

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Association Approval: WALA TRINITY SENIOR COMMUNITY 5575 (0013817) 5575 BURKE RD MADISON WI 53718 (608) 245-1198 DAMON FREI County: DANE

TRINITY SENIOR COMMUNITY II LLC (847) 692-1152 BENJAMIN ISRAEL 6400 SHAFER CT #700 ROSEMONT IL 60018

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,105/5,035 Initial License: 10/07/2011

Type: Class:

Association Approval: WALA WAUNAKEE MANOR CBRF RETIREMENT WING (110316) 801 S KLEIN DR WAUNAKEE WI 53597 (608) 849-5016 DAVE KRUCHTEN County: DANE WHITNEY LODGE II (THE) (0011717) 209 N WHITNEY WAY MADISON WI 53705 (608) 819-0475 EUMIJAH MILLER-WILLIAMS County: DANE WILLOW POINTE MEMORY CARE LLC (0009421) 143 PRAIRIE OAKS DR VERONA WI 53593 (608) 848-5601 KATIE RASMUSSEN County: DANE WOMEN IN TRANSITION (110025) 2842 MOLAND ST MADISON WI 53704 (608) 244-2046 KATHLEEN LEMKE County: DANE WYNWOOD MADISON WEST (110331) 413 S YELLOWSTONE DR MADISON WI 53719 (608) 277-1010 WILLIAM BROTZMAN County: DANE ARCADIA COMMUNITIES (0013631) 911 S CENTER ST BEAVER DAM WI 53916 (920) 219-9517 DEANN NEITZEL County: DODGE

WAUNAKEE MANOR RETIREMENT MNGMNT C (608) 849-5016 DAVE KRUCHTEN 801 S KLEIN DR WAUNAKEE WI 53597 (608) 239-5345 EUMIJAH MILLER-WILLIAMS 7659 FARMINGTON WAY MADISON WI 53717 SENIOR SOLUTIONS INC (608) 224-1666 ED MEIER 143 PRAIRIE OAKS DRIVE VERONA WI 53593 WOMEN IN TRANSITION INC (608) 244-2046 KATHLEEN LEMKE 2842 MOLAND ST MADISON WI 53704 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 WILLIAM BROTZMAN 413 S YELLOWSTONE DR MADISON WI 53719 ARCADIA COMMUNITIES LLC (920) 387-5840 ROGER THIMM W2874 GRAYLOG RD IRON RIDGE WI 53035

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,400/3,300 Initial License: 08/01/1991

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,500/10,000 Initial License: 04/06/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,000/4,500 Initial License: 08/16/2001

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 12 Low/High rate: 2,171/2,171 Initial License: 08/31/1980

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 3,285/4,160 Initial License: 02/04/1992

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,500/6,000 Initial License: 04/01/2011

Type: Class:

BETHESDA LUTHERAN COMMUNITIES EGGLESTON (000 103 EGGLESTON ST FOX LAKE WI 53933 (920) 928-2588 DEANNA JARMUZ County: DODGE BETHESDA LUTHERAN COMMUNITIES O'CONNELL (0009 205 O'CONNELL ST FOX LAKE WI 53933 (920) 928-2252 BROOKE WIELGOSH County: DODGE

BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,899/4,899 Initial License: 12/05/2001

Type: Class:

CBRF CA Gender - Capacity: M/F - 6 Low/High rate: 4,468/4,468 Initial License: 12/05/2001

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 25

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 4,350/4,350 Initial License: 01/15/2011

Type: Class:

CHARLESTON HOUSE CBRF (0013555) 129 EVERGREEN LANE BEAVER DAM WI 53916 (920) 210-3835 JILL FAKES County: DODGE CHRISTIAN HOMESTEAD (0009149) 1001 WEST BROWN ST WAUPUN WI 53963 (920) 324-6560 KATE MILLER County: DODGE DAYBREAK INC HORICON (110532) 822 E WALNUT ST HORICON WI 53032 (920) 485-4010 FRANK WILL County: DODGE DAYBREAK INC WAUPUN (110539) 631 S MADISON ST WAUPUN WI 53963 (920) 324-4903 FRANK WILL County: DODGE EAGLES WINGS (111039) 408 STONE ST BEAVER DAM WI 53916 (920) 885-9700 MICHELLE PASBRIG County: DODGE Association Approval: Leading Age EVERGREEN MANOR III INC (0011807) 239 VICTORY ST JUNEAU WI 53039 (920) 386-9012 CINDY WEISENSEL County: DODGE GOLDEN YEARS OF RANDOLPH I (0011820) 131 ELLIS AVE RANDOLPH WI 53956 (920) 326-4663 JANIS DEETS NOWAK County: DODGE Association Approval: GOLDEN YEARS OF RANDOLPH II (0011821) 137 ELLIS AVE RANDOLPH WI 53956 (920) 326-4663 JANIS DEETS NOWAK County: DODGE Association Approval: HERITAGE HOMES ASSISTED LIVING (0013392) 700 WELSH RD WATERTOWN WI 53098 (920) 206-9448 JAN ZIMMERMAN County: DODGE

CHARLESTON HOUSE LLC (920) 210-3835 GAIL FAKES W10204 INLET RD FOX LAKE WI 53933 CHRISTIAN HOME & REHABILITATION CENTER I (920) 324-6560 KATE MILLER 1001 WEST BROWN ST WAUPUN WI 53963 DAYBREAK INC (920) 485-4010 FRANK WILL 822 E WALNUT ST HORICON WI 53032 DAYBREAK INC (920) 485-4010 FRANK WILL 631 S MADISON ST WAUPUN WI 53963 BEAVER DAM COMMUNITY HOSPITALS INC (920) 887-5902 JOHN E. LEY 707 S UNIVERSITY AVE BEAVER DAM WI 53916 JIM AND LARENDA ROSIN (920) 229-3664 JIM ROSIN PO BOX 506 SPARTA WI 54656 GOLDEN YEARS OF RANDOLPH LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST PORTAGE WI 53901 GOLDEN YEARS OF RANDOLPH LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST PORTAGE WI 53901 HERITAGE ASSISTED LIVING OF WATERTOWN L (920) 206-9448 JAN ZIMMERMAN 700 WELSH RD WATERTOWN WI 53098

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 3,836/4,247 Initial License: 12/04/2000

Type: Class:

Gender - Capacity:

CBRF AA M/F - 12 Low/High rate: 3,726/3,726 Initial License: 02/01/1980

Type: Class: Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,757/4,757 Initial License: 01/01/1995 CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,350/3,850 Initial License: 09/08/1997

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,000/3,900 Initial License: 02/19/2007

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

Gender - Capacity:

CBRF CNA M/F - 9 Low/High rate: 2,800/3,900 Initial License: 04/26/2007

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 9 Low/High rate: 2,800/3,900 Initial License: 04/26/2007

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 46 Low/High rate: 3,960/6,061 Initial License: 11/08/2010

Type: Class:

Association Approval: Leading Age HIGHLAND HOUSE (110540) 125A HOSPITAL DR WATERTOWN WI 53098 (920) 262-4823 JANICE WEBER-HELMS County: DODGE

WATERTOWN MEMORIAL HOSPITAL (920) 262-4218 GERALD F ROCHE 125A HOSPITAL DR WATERTOWN WI 53098

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,675/4,925 Initial License: 06/30/1995

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 26

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 8,359/8,359 Initial License: 12/21/2006

Type: Class:

HIL MEADOWBROOK (0011747) 1405 WEDGEWOOD CRT WATERTOWN WI 53098 (262) 490-0234 AMY DZIOBA County: DODGE MACKIE STREET GROUP HOME (110529) 216 W MACKIE ST BEAVER DAM WI 53916 (920) 885-2322 JAN BAUMGARTNER County: DODGE MARVINS MANOR II (0012372) 839 DIVISION ST HORICON WI 53032 (920) 485-4016 BARBARA HENDRICKS County: DODGE MARVINS MANOR III (0013021) 209 FOREST ST FOX LAKE WI 53933 (920) 520-0040 BARBARA A HENDRICKS County: DODGE MOSSFLOWER HARBOUR II (0010813) 175 RIVERVIEW HEIGHTS MAYVILLE WI 53050 (920) 387-9550 MARIA CAMPBELL County: DODGE PINE RIDGE HOUSE (0013335) N844 CRAWFISH RD IXONIA WI 53036 (920) 474-3142 PAULA HEYER County: DODGE PRAIRIE RIDGE ASSISTED LIVING (0012604) 819 WILCOX ST WAUPUN WI 53963 (920) 324-5450 BONNIE KARTHEISER County: DODGE PRAIRIE RIDGE ASSISTED LIVING (0012224) 212 EAST INDUSTRIAL DR BEAVER DAM WI 53916 (920) 356-0032 RACHEL CHRISTIAN County: DODGE REMEMBRANCE HOME (0009159) 1810 N SPRING ST BEAVER DAM WI 53916 (920) 356-9015 KATHY BATES County: DODGE Association Approval: Leading Age SYLVAN CROSSINGS AT HUNTER RIDGE (111056) 626 MONROE ST BEAVER DAM WI 53916 (920) 885-1790 NICHOLE TER BEEST County: DODGE TOUCHSTONE OF MAYVILLE (0013818) 1071 HORICON ST MAYVILLE WI 53050 (920) 644-2195 MICHELLE CARPENTER County: DODGE ZINZENDORF HALL INC (110538) 1148 BAYBERRY DR WATERTOWN WI 53098 (920) 206-4932 SHERRY CIRA County: DODGE Association Approval: Leading Age

HOMES FOR INDEPENDENT LIVING (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094-3749 BARBARA HENDRICKS (920) 324-5359 BARBARA HENDRICKS 839 DIVISION ST HORICON WI 53032 BARBARA A HENDRICKS (920) 324-5359 BARBARA A HENDRICKS 219 FOND DU LAC ST WAUPUN WI 53963 MARIA CAMPBELL (920) 387-4154 MARIA CAMPBELL 616 N MAIN ST MAYVILLE WI 53050 AFFINITY HEALTH CARE LLC (414) 303-8866 THOMAS SCHILLING 8208 RACINE AVE WIND LAKE WI 53185 ADVANTAGE MANAGEMENT LLC (920) 623-5621 CATHERINE HALFMANN 819 WILCOX ST WAUPUN WI 53963 ADVANTAGE MANAGEMENT LLC (920) 623-5621 MICHAEL EISENGA N4365 HWY 73 COLUMBUS WI 53925 BEAVER DAM COMMUNITY HOSPITALS INC (920) 887-5902 KATHY BATES 1810 NORTH SPRING STREET BEAVER DAM WI 53916 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 TOUCHSTONE LIVING CARE LLC (262) 412-4002 ROBERT K TURNER 7945 31ST AVE KENOSHA WI 53142 ZINZENDORF HALL INC (920) 206-4932 MATT MAUTHE 1020 HILL ST WATERTOWN WI 53098

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,449/2,449 Initial License: 05/15/1991

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,050/3,750 Initial License: 09/08/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,050/3,750 Initial License: 11/18/2009

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 3,500/5,000 Initial License: 12/21/2004

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 4,000/6,000 Initial License: 10/05/2010

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,000/3,900 Initial License: 12/02/2008 CBRF CNA Gender - Capacity: M/F - 34 Low/High rate: 3,000/3,900 Initial License: 04/15/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,790/3,790 Initial License: 12/22/2000

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,010/4,660 Initial License: 03/27/1998

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 6,300/10,500 Initial License: 09/29/2011

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 48 Low/High rate: 3,950/5,000 Initial License: 11/16/1989

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 27

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 70 Low/High rate: 2,950/4,400 Initial License: 11/08/2012

Type: Class:

ANNAS HEALTHCARE INC (0014311) 839 S 18TH AVE STURGEON BAY WI 54235 (920) 783-6331 TAMA A BEGLEY County: DOOR CARDINAL RIDGE RESIDENTIAL CARE (0010030) 817 CIRCLE RIDGE PLACE STURGEON BAY WI 54235 (920) 743-9289 KAREN BAIN County: DOOR GATHERING OF DOOR COUNTY (THE) (0008736) 204 N DULUTH AVE STURGEON BAY WI 54235 (920) 746-7550 KATHY HOWLETT DESPOT County: DOOR HEARTHSIDE (410502) 10569 FIELDCREST RD SISTER BAY WI 54234 (920) 854-7225 MARTHA COVENTRY County: DOOR HIL FLORIDA (0012185) 1921 FLORIDA ST STURGEON BAY WI 54235 (920) 746-2975 DAVID HOFFMANN County: DOOR WHISPERING HEIGHTS (0013300) 1704 GEORGIA ST STURGEON BAY WI 54235 (920) 746-8998 AMANDA TWEEDY County: DOOR WHISPERING PINES (0013302) 1610 GEORGIA ST STURGEON BAY WI 54235 (920) 746-7080 AMANDA TWEEDY County: DOOR WHISPERING WINDS (0013287) 1632 GEORGIA ST STURGEON BAY WI 54235 (920) 746-8859 AMANDA TWEEDY County: DOOR WOODVIEW OF SCANDIA (410210) 2311 MEADOW WOOD DR SISTER BAY WI 54234 (920) 854-2317 MICHELE NOTZ County: DOOR Association Approval: Leading Age CEDAR RIDGE ASSISTED LIVING & MEMORY CARE (001 4519 E MARQUARDT RD SUPERIOR WI 54880 (715) 392-0610 AMY SKAGGS County: DOUGLAS COUNTRY COMPANIONS - LAKE NEBAGAMON (0012741) 11419 E 1ST STREET NORTH LAKE NEBAGAMON WI 54849 (715) 374-2848 MARILYN HAUTAMAKI County: DOUGLAS CYPRESS HOUSE CBRF (510320) 1415 CYPRESS AVE SUPERIOR WI 54880 (715) 392-8997 KATIE BACKLUND County: DOUGLAS

TAMA A BEGLEY (920) 366-8856 TAMA A BEGLEY 4999 PLACID WAY NEW FRANKEN WI 54229 CARDINAL RIDGE RESIDENTIAL CARE (920) 434-9600 KAREN BAIN PO BOX 11966 GREEN BAY WI 54307-1966 CORNERSTONE OF STURGEON BAY LLC (414) 570-9755 KATHY HOWLETT DESPOT 204 N DULUTH AVE STURGEON BAY WI 54235 CORDIAL CARE CORP (920) 854-4501 MARTHA COVENTRY 10569 FIELDCREST RD SISTER BAY WI 54234 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 ELDER INNOVATIONS LLC (608) 442-8005 DOUGLAS HENNIG 5976 EXECUTIVE DR STE B MADISON WI 53719 ELDER INNOVATIONS LLC (608) 442-8005 DOUGLAS HENNIG 5976 EXECUTIVE DR STE B MADISON WI 53719 ELDER INNOVATIONS LLC (608) 442-8005 DOUGLAS HENNIG 5976 EXECUTIVE DR STE B MADISON WI 53719 EVANGELICAL LUTHERAN GOOD SAMARITAN (920) 854-2317 MICHELE NOTZ 10560 APPLEWOOD RD SISTER BAY WI 54234 CEDAR RIDGE ASSISTED LIVING & MEMORY C (715) 394-7466 DEANNA PETERSON 4561 E MARQUARDT RD SUPERIOR WI 54880 FREE BIRD LLC (715) 374-2717 MARILYN HAUTAMAKI 11419 E 1ST STREET NORTH LAKE NEBAGAMON WI 54849 CHALLENGE CENTER INC (715) 394-2771 KELLY JOHNSON 39 N 25TH ST EAST SUPERIOR WI 54880

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 2,625/3,400 Initial License: 04/01/2003

Type: Class:

CBRF CS Gender - Capacity: M/F - 19 Low/High rate: 2,650/3,600 Initial License: 01/05/2000

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,800/4,750 Initial License: 05/01/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 7,350/7,350 Initial License: 11/15/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 2,200/3,800 Initial License: 05/24/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 2,200/3,800 Initial License: 05/24/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,200/3,800 Initial License: 05/24/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,896/3,469 Initial License: 01/01/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,500/4,900 Initial License: 02/01/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,900/7,100 Initial License: 03/30/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 3,000/4,620 Initial License: 05/12/1989

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 28

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 2,914/5,146 Initial License: 10/19/1981

Type: Class:

DEER HAVEN (510005) 3105 CUMMING AVE SUPERIOR WI 54880 (715) 392-5427 KELLY JOHNSON County: DOUGLAS ENCOMPASS ASSISTED LIVING - FAXON HOUSE (00137 1212 FAXON STREET SUPERIOR WI 54880 (715) 395-3733 THERESA KELLY County: DOUGLAS ENCOMPASS HEALTHCARE CBRF II (0013513) 1500 N 34TH ST STE 500 SUPERIOR WI 54880 (715) 398-8710 MELISSA SORENSON County: DOUGLAS HARBORVIEW CBRF (510321) 910 E 5TH ST SUPERIOR WI 54880 (715) 394-3226 GEORGE HIRVELA County: DOUGLAS HARMONY HOUSE II (0011526) 7613 JOHN AVE SUPERIOR WI 54880 (715) 392-7644 PAMELA CLARK County: DOUGLAS HARMONY KC LLC (0010434) 7615 JOHN AVE SUPERIOR WI 54880 (715) 392-7615 PAMELA CLARK County: DOUGLAS INNOVATIVE LIVING OF WISCONSIN INC (0013168) 1500 N 34TH ST STE 600 SUPERIOR WI 54880 (218) 624-7005 MATT GANNUCCI County: DOUGLAS LIGHTHOUSE OF SUPERIOR CBRF-BETTYS HARBOR (001 1915 N 34TH ST SUPERIOR WI 54880 (218) 721-2800 BRIAN PATTERSON County: DOUGLAS MCKENZIE MANOR (0009412) 3317 NORTH 21ST STREET SUPERIOR WI 54880 (715) 399-0900 GEORGE HIRVELA County: DOUGLAS MOUNTAIN VIEW HOME (0009539) 3319 N 16TH STREET SUPERIOR WI 54880 (715) 392-3038 KRISTEN ABRAHAMSON County: DOUGLAS NORTHERN RESIDENCE (0012127) 6857 S COUNTY RD E HAWTHORNE WI 54842 (715) 374-3358 GREGORY SWANSON County: DOUGLAS REM WISCONSIN III INC 21ST STREET (0009561) 3901 N 21ST STREET SUPERIOR WI 54880 (715) 395-2821 SHELLEY HANSEN-BLAKE County: DOUGLAS

CHALLENGE CENTER INC (715) 394-2771 KELLY JOHNSON 39 N 25TH ST EAST SUPERIOR WI 54880 ENCOMPASS HEALTHCARE & ASSISTED LIVI (715) 392-2780 MATT GANNUCCI 1225 TOWER AVENUE SUITE 228 SUPERIOR WI 54880 ENCOMPASS HEALTHCARE AND ASSISTED LI (715) 392-2780 MATT GANNUCCI 1225 TOWER AVE STE 228 SUPERIOR WI 54880 CHALLENGE CENTER INC (715) 394-2771 KELLY JOHNSON 39 N 25TH ST E SUPERIOR WI 54880 PAMELA CLARK (715) 394-7120 PAMELA CLARK 7615 JOHN AVE SUPERIOR WI 54880 PAMELA CLARK (715) 394-7120 PAMELA CLARK 4463 E SINGKOFER RD SUPERIOR WI 54880 INNOVATIVE LIVING OF WISCONSIN INC (715) 392-2780 MATT GANNUCCI 1225 TOWER AVE STE 228 SUPERIOR WI 54880 SUPERIOR OPS LLC (218) 721-2800 SCOTT MCCUTCHEON 7625 GOLDEN TRIANGLE DR STE T EDEN PRAIRIE MN 55344 CHALLENGE CENTER INC (715) 394-2771 KELLY JOHNSON 39 NORTH 25TH STREET EAST SUPERIOR WI 54880 CHALLENGE CENTER INC (715) 394-2771 KELLY JOHNSON 39 N 25TH ST E SUPERIOR WI 54880 GREGORY M SWANSON (218) 348-1795 GREGORY M SWANSON P O BOX 160 HAWTHORNE WI 54842-0160 REM WISCONSIN INC (608) 276-1191 SHELLY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 2,500/10,000 Initial License: 07/29/2011

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,500/10,000 Initial License: 03/03/2011

Type: Class:

ADVANCED AGED

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 3,096/3,416 Initial License: 01/03/1989

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,885/4,340 Initial License: 08/10/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,885/4,030 Initial License: 02/17/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 1,500/6,000 Initial License: 03/17/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 44 Low/High rate: 4,850/6,066 Initial License: 11/11/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 4,802/8,265 Initial License: 09/07/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,047/8,876 Initial License: 02/26/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 7 Low/High rate: 3,000/3,500 Initial License: 12/01/2007

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,865/4,279 Initial License: 03/19/2002

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 29

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,865/4,279 Initial License: 03/19/2002

Type: Class:

REM WISCONSIN III INC BELKNAP (0009560) 3706 BELKNAP ST SUPERIOR WI 54880 (715) 395-2815 SHELLEY HANSEN-BLAKE County: DOUGLAS STARDUSK HOUSE (0010459) 7619 JOHN AVE SUPERIOR WI 54880 (715) 394-3553 SUSAN DATE County: DOUGLAS TRADEWINDS RESIDENCE INC (510325) 1601 N 16TH ST SUPERIOR WI 54880 (715) 394-2077 ROBIN KULASZEWICZ County: DOUGLAS ARBOR PLACE INC (510113) 320 21ST ST NE MENOMONIE WI 54751 (715) 235-4537 JILL GAMEZ County: DUNN AURORA RES ALTERNATIVES INC 011 (0009573) 1306 12TH AVENUE SE MENOMONIE WI 54751 (715) 233-1299 PAIGE MEIER County: DUNN AURORA RESIDENTIAL ALT INC #010 (0011477) 2412 THIRD ST E MENOMONIE WI 54751 (715) 235-0290 PAIGE MEIER County: DUNN CARE PARTNERS ASSTD LIVING MENOMONIE (0009882) 1902 TALEN ST MENOMONIE WI 54751 (715) 235-6333 PAM KEGLEY County: DUNN CLEAR VIEW (510015) N5017 970TH STREET ELK MOUND WI 54739-9365 (715) 879-5696 LINDSAY FARRELL County: DUNN COMFORTS OF HOME - MENOMONIE CBRF (0013677) 2211 WHITE PINE LANE MENOMONIE WI 54751 (715) 231-3020 SARAH LYBARGER County: DUNN COUNTRY TERRACE MENOMONIE (0009880) 1916 TALEN ST MENOMONIE WI 54751 (715) 235-5112 PAM KEGLEY County: DUNN NOREEN FAMILY HOME (0010740) 2913 INGALLS RD MENOMONIE WI 54751 (715) 235-4657 DEANNA EBERT County: DUNN OUR HOUSE MEMORY CARE (0013428) 820-17TH AVENUE MENOMONIE WI 54751 (715) 232-8181 JENNY SWANSON County: DUNN

REM WISCONSIN INC (608) 276-1191 SHELLY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 GEORGE DATE INC DBA STARDUSK HOUSE (715) 394-3553 SUSAN/GREG DATE 7619 JOHN AVE SUPERIOR WI 54880 TRADEWINDS RESIDENCE INC (218) 728-9295 JOHN KOLAR 1601 NORTH 16TH STREET SUPERIOR WI 54880 ARBOR PLACE INC (715) 235-4537 JILL GAMEZ 320 21ST ST NE MENOMONIE WI 54751 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E SUITE B MENOMONIE WI 54751 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DRIVE E STE B MENOMONIE WI 54751 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903-3006 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 MENOMONIE CBRF, LLC (651) 287-0265 RHONDA SCHILLINGER 750 MAIN STREET, SUITE 200 MENDOTA HEIGHTS MN 55118 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903-3006 NOREEN FAMILY HOMES, INC (715) 308-4500 DEANNA EBERT E5901 - 800TH AVE MENOMONIE WI 54751 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,197/4,441 Initial License: 02/24/2004

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 20 Low/High rate: 3,954/4,028 Initial License: 05/13/1994

Type: Class:

Gender - Capacity:

CBRF AA M/F - 16 Low/High rate: 2,261/4,626 Initial License: 01/01/1980

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,468/6,274 Initial License: 03/01/2002

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,350/7,202 Initial License: 06/19/2006 CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,600/4,050 Initial License: 10/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 5,239/5,239 Initial License: 01/05/1987

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 3,700/4,500 Initial License: 04/01/2011

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,652/3,702 Initial License: 08/07/2003

Type: Class:

CBRF CS Gender - Capacity: M - 8 Low/High rate: 2,650/2,650 Initial License: 12/06/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,600/3,650 Initial License: 09/30/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 30

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 15 Low/High rate: 2,300/4,300 Initial License: 08/01/2005

Type: Class:

POTTERS COUNTRY HOME (0010954) N3430 STATE RD 25 MENOMONIE WI 54751 (715) 235-6789 RACHEL SELCHOW County: DUNN TARA PLACE (510292) N5160 97OTH STREET ELK MOUND WI 54739 (715) 879-5381 LINDSAY FARRELL County: DUNN AFFINITY HOUSE (510031) 3042 KILBOURNE AVENUE EAU CLAIRE WI 54703 (715) 833-0436 ANITA KUSTER County: EAU CLAIRE APPLE TREE COTTAGE CBRF (0013306) 1306 KEITH ST EAU CLAIRE WI 54701 (715) 952-7316 LYNN HOEHN-OLSON County: EAU CLAIRE AZURA MEMORY CARE (0009389) 3712 DAMON STREET EAU CLAIRE WI 54701 (715) 832-6696 DEBBIE DECKER County: EAU CLAIRE CARE PARTNERS ASSISTD LIVING LINDEMANN HOUSE ( 2320 FRANK STREET EAU CLAIRE WI 54703 (715) 858-3423 LORNA OLSON County: EAU CLAIRE CARE PARTNERS ASSISTED LIVING LLC (0009047) 2306 FRANK STREET EAU CLAIRE WI 54703 (715) 835-6656 LORNA OLSON County: EAU CLAIRE COUNTRY TERRACE-ALTOONA (0011743) 1511 DEVNEY DR ALTOONA WI 54720 (715) 836-9211 KATHLEEN STELZLENI County: EAU CLAIRE FAHRMAN CENTER (510019) 3136 CRAIG ROAD EAU CLAIRE WI 54701 (715) 835-9110 RICHARD WILLIAMS County: EAU CLAIRE FAMILY TREE (510296) 2005 AGNES STREET EAU CLAIRE WI 54701 (715) 832-3663 PAMELA SMITH County: EAU CLAIRE GRACE EDGEWOOD (510138) 2512 SPOONER AVE ALTOONA WI 54720 (715) 832-5813 BARBARA MUELLER County: EAU CLAIRE Association Approval: Leading Age GRACE WOODLANDS (0012384) 3214 GALA ST EAU CLAIRE WI 54703 (715) 831-8100 BARBARA MUELLER County: EAU CLAIRE Association Approval: Leading Age

POTTERS COUNTRY HOME (715) 235-6739 RACHEL SELCHOW N3426 STATE HWY 25 MENOMONIE WI 54751 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 LUTHERAN SOC SERV OF WI & UPPER MI INC (715) 834-2046 ANITA KUSTER 3042 KILBOURNE AVE EAU CLAIRE WI 54703 THOMAS C KITE (715) 835-4764 THOMAS KITE 516 GALLOWAY ST EAU CLAIRE WI 54703 AZURA HARBOR HOLDINGS LLC (608) 836-5070 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903-3006 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54902 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54902 LUTHERAN SOC SERV OF WI & UPPER MI (715) 834-2046 RICHARD WILLIAMS 3136 CRAIG ROAD EAU CLAIRE WI 54701 (715) 834-8098 PAMELA E SMITH 2005 AGNES STREET EAU CLAIRE WI 54701 GRACE LUTHERAN FOUNDATION INC (715) 832-3003 BARBARA MUELLER P O BOX 287 EAU CLAIRE WI 54702-0287 GRACE LUTHERAN FOUNDATION INC (715) 832-3002 MICHAEL CHRISTENSEN P O BOX 287 EAU CLAIRE WI 54702-0287

ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,332/5,332 Initial License: 08/20/1996

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 18 Low/High rate: 1,598/1,598 Initial License: 04/01/1988

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 1,645/6,740 Initial License: 05/21/2010

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,500/5,500 Initial License: 03/01/2002

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,550/4,100 Initial License: 11/27/2002

Type: Class:

CBRF CNA Gender - Capacity: F - 14 Low/High rate: 1,945/3,645 Initial License: 06/01/2000

Type: Class:

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 2,450/3,227 Initial License: 12/11/2006

Type: Class:

CBRF AA Gender - Capacity: M/F - 44 Low/High rate: 3,545/4,763 Initial License: 08/31/1987

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 1,800/3,000 Initial License: 06/01/1996

Type: Class:

CBRF CNA Gender - Capacity: M/F - 44 Low/High rate: 1,890/2,610 Initial License: 04/15/1986

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 34 Low/High rate: 2,550/4,175 Initial License: 05/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 31

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 3,400/3,900 Initial License: 11/01/2007

Type: Class:

HERITAGE COURT (0011976) 3515 E HAMILTON AVE EAU CLAIRE WI 54701 (715) 831-8200 KAREN SCHACHT County: EAU CLAIRE LIBERTY VIEW (510042) 611 MAIN ST EAU CLAIRE WI 54701 (715) 834-4001 LINDSAY FARRELL County: EAU CLAIRE MARSTON GROUP HOME (0008905) 403 MARSTON STREET EAU CLAIRE WI 54701 (715) 835-0323 LYNN HOEHN-OLSON County: EAU CLAIRE MCCORMICK FAMILY CIRCLE (0010592) 1018 GRAHAM AVE EAU CLAIRE WI 54701 (715) 833-9592 ANDREW MCCORMICK County: EAU CLAIRE MILESTONE SENIOR LIVING MEMORY CARE (0012569) 5510 RENEE DRIVE EAU CLAIRE WI 54703 (715) 874-4232 KELLY RIVARD County: EAU CLAIRE MORNING VIEW II (510164) 440 SUNDAY DRIVE ALTOONA WI 54720 (715) 514-2000 LINDSAY FARRELL County: EAU CLAIRE MT WASHINGTON RESIDENCE (510142) 1930 CLEVELAND ST EAU CLAIRE WI 54703 (715) 834-3400 DEBRA SCHWAGEL County: EAU CLAIRE OAK VIEW II (510040) S10580 CO HWY B PO BOX 115 ELEVA WI 54738 (715) 835-6970 LINDSAY FARRELL County: EAU CLAIRE ORCHARD HILLS (510381) 1403 TRUAX BLVD EAU CLAIRE WI 54703 (715) 552-1030 KIM NEUENBURG County: EAU CLAIRE Association Approval: WiCAL OUR HOUSE MEMORY CARE (0013430) 733 W HAMILTON AVE EAU CLAIRE WI 54701 (715) 832-3970 JENNY SWANSON County: EAU CLAIRE PRAIRIE VIEW (510043) 6808 W CAMERON ST EAU CLAIRE WI 54703 (715) 874-6713 LINDSAY FARRELL County: EAU CLAIRE ROSE VIEW (510209) 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 (715) 874-6622 LINDSAY FARRELL County: EAU CLAIRE

HERITAGE-5 LLC (952) 351-4542 MORGAN LEININGER 3515 E HAMILTON AVE EAU CLAIRE WI 54701 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 THOMAS C KITE (715) 832-6333 THOMAS KITE 516 GALLOWAY STREET EAU CLAIRE WI 54703 ANDREW MCCORMICK (715) 833-9592 ANDREW MCCORMICK 1018 GRAHAM AVE EAU CLAIRE WI 54701 MILESTONE SENIOR LIVING (608) 819-2200 JULIE HEIL 1574 W BROADWAY STE 200 MADISON WI 53713 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 HEYDE HEALTH SYSTEM INC (715) 726-9094 MARTIN METTEN 345 FRENETTE DR CHIPPEWA FALLS WI 54729 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 MEADOWLARK HEALTH SERVICES LLC (715) 552-1030 KIM NEUENBURG 1403 TRUAX BLVD EAU CLAIRE WI 54703 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,201/5,201 Initial License: 02/01/1984

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,674/4,464 Initial License: 02/04/2000

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 8 Low/High rate: 1,423/1,620 Initial License: 06/01/2004

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,900/4,050 Initial License: 11/24/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 8,246/8,246 Initial License: 02/08/1989

Type: Class:

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 1,797/3,672 Initial License: 10/01/1988

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 6,913/6,913 Initial License: 07/09/1984

Type: Class:

CBRF CNA Gender - Capacity: M/F - 39 Low/High rate: 3,200/3,200 Initial License: 03/23/1999

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,890/4,640 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,859/5,859 Initial License: 01/26/1983

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 8,246/8,246 Initial License: 10/14/1991

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 32

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 7,037/7,037 Initial License: 12/13/1993

Type: Class:

TIMBER VIEW (510256) S8560 BALSAM ROAD EAU CLAIRE WI 54701 (715) 878-4699 LINDSAY FARRELL County: EAU CLAIRE TRINITEAM HALFWAY HOUSE (510062) 628 N BARSTOW ST EAU CLAIRE WI 54703 (715) 836-8118 ROBERT LAFORTUNE County: EAU CLAIRE VALLEY VIEW (510064) 2720 NORTH TOWNHALL RD EAU CLAIRE WI 54703 (715) 874-6390 LINDSAY FARRELL County: EAU CLAIRE ARC FOND DU LAC (410551) 27 E THIRD ST 208 FOND DU LAC WI 54935 (920) 907-0460 TANIA RHOADS County: FOND DU LAC ARC PARK AVE GROUP HOME (410005) 100 N PARK AVE FOND DU LAC WI 54935 (920) 923-3570 AMY WILCOX County: FOND DU LAC ARTISAN FOND DU LAC HOUSE (THE) (0014427) 154 S PIONEER PKWY FOND DU LAC WI 54935 (920) 921-3993 ERICA RACINE County: FOND DU LAC AUTUMN BAY OF RIPON (0014074) 1450 PLEASANT ST RIPON WI 54971 (866) 547-4698 LORI PAPROCKI County: FOND DU LAC

BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 TRINITEAM INC (715) 836-8106 ROBERT LAFORTUNE 628 N BARSTOW ST EAU CLAIRE WI 54703 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 LINDSAY FARRELL 2710 NORTH TOWN HALL ROAD EAU CLAIRE WI 54703 ARC COMMUNITY SERVICES INC (608) 278-2300 KAREN KINSEY 2001 W BELTLINE HWY STE 102 MADISON WI 53713 ARC OF FOND DU LAC INC (920) 923-3810 DAVID BOELTER 500 N PARK AVE FOND DU LAC WI 54935 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 HEALTHSPAN (414) 840-3981 LORI PAPROCKI 5520 W FOREST HOME AVE GREENFIELD WI 53220

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 14 Low/High rate: 2,280/2,280 Initial License: 07/01/1985

Type: Class:

CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,859/5,859 Initial License: 08/01/1985

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 14 Low/High rate: 2,328/2,328 Initial License: 04/17/1998

Type: Class:

CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 2,559/2,559 Initial License: 09/01/1986

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,400/4,000 Initial License: 12/01/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,400/6,000 Initial License: 04/30/2012

Type: Class:

BARRETT HOUSE INC (0012443) 632 HILLTOP RIPON WI 54971 (920) 748-2999 BARBARA REIF County: FOND DU LAC

BARBARA J REIF (920) 398-2989 BARBARA REIF 185 E JOHN ST MARKESAN WI 53946

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,950/3,600 Initial License: 08/12/2008

Type: Class:

BEACON HOUSE (410343) 166 S PARK AVE FOND DU LAC WI 54935 (920) 923-3999 MARY GERLACH County: FOND DU LAC BETHESDA LUTHERAN COMMUNITIES - 107 UPLAND (00 107 UPLAND DR BRANDON WI 53919 (920) 346-2410 ROBERT SERVAIS County: FOND DU LAC BETHESDA LUTHERAN COMMUNITIES - 109 UPLAND (00 109 UPLAND DR BRANDON WI 53919 (920) 346-2105 MEGHAN LAPOINT County: FOND DU LAC

FRIENDS OF WOMEN IN RECOVERY INC (920) 923-3999 MARY GERLACH 166 S PARK AVE FOND DU LAC WI 54935 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094

Gender - Capacity:

CBRF AA F - 12 Low/High rate: 3,080/3,410 Initial License: 06/01/1993

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 4,351/4,351 Initial License: 07/24/2003

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 5,525/5,525 Initial License: 11/15/2004

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 33

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,830/5,830 Initial License: 11/15/2004

Type: Class:

BETHESDA LUTHERAN COMMUNITIES - FDL 21ST STRE ( 37 & 43 21ST ST FOND DU LAC WI 54935 (920) 922-2094 JENNIFER JJFISCHER County: FOND DU LAC BLANDINE HOUSE INC (410007) 25 N PARK AVE FOND DU LAC WI 54935 (920) 922-9487 PETER BAERTSCHY County: FOND DU LAC DEERVIEW MEADOWS OF FOND DU LAC I (0010855) 496 WISCONSIN CT FOND DU LAC WI 54937 (920) 921-5115 TERRI WERNER County: FOND DU LAC

BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BLANDINE HOUSE INC (920) 922-9487 PETER BAERTSCHY 25 N PARK AVE FOND DU LAC WI 54935 DEERVIEW MEADOWS ASSISTED LIVING LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT #5 MADISON WI 53713

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 12 Low/High rate: 1,820/2,015 Initial License: 02/01/1980

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 2,600/3,300 Initial License: 02/05/2005

Type: Class:

EDEN HOUSE (0010661) W4716 HWY B EDEN WI 53019 (920) 477-4500 GEORGIANN FROEMKE County: FOND DU LAC FRANKLIN HOUSE (410009) 349 W 11TH ST FOND DU LAC WI 54935 (920) 921-7568 JEAN KUNTZ County: FOND DU LAC

LIFELINE SERVICES OF FOND DU LAC INC (920) 922-4068 GEORGIANN FROEMKE 13 SIXTH ST FOND DU LAC WI 54935 RESIDENTIAL SERVICES INC (920) 922-7072 ANN CALNIN 342 FOREST AVE FOND DU LAC WI 54935

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,414/4,755 Initial License: 12/28/2004

Type: Class:

CBRF AS Gender - Capacity: M/F - 12 Low/High rate: 1,684/2,356 Initial License: 02/10/1984

Type: Class:

IVY MANOR OF CAMPBELLSPORT (0011093) 280 N BAUMANN ST CAMPBELLSPORT WI 53010 (920) 533-4300 SUSAN POLSTER County: FOND DU LAC KINDREDHEARTS FOND DU LAC (0011452) 566 SHERWOOD AVE FOND DU LAC WI 54935 (920) 924-8011 MIRANDA SEGHERS County: FOND DU LAC LIBERTY HOUSE (410513) 701 S MAIN ST FOND DU LAC WI 54935 (920) 922-5445 JUDITH JONES County: FOND DU LAC LINCOLN HOUSE (410289) 342 FOREST AVE FOND DU LAC WI 54935 (920) 922-9554 KAREN KELM County: FOND DU LAC

HCS FAMILY INVESTMENTS (262) 305-1209 SUSAN POLSTER 280 N BAUMANN ST CAMPBELLSPORT WI 53010 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 MIRANDA SEGHERS 566 SHERWOOD AVE FOND DU LAC WI 54935 LIBERTY HOUSE LLC (920) 922-5445 JUDITH JONES 701 S MAIN ST FOND DU LAC WI 54935 RESIDENTIAL SERVICES INC (920) 922-7072 ANN CALNIN 342 FOREST AVE FOND DU LAC WI 54935

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/4,000 Initial License: 01/03/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,000/5,500 Initial License: 05/01/2006

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,250/2,850 Initial License: 06/16/1997

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 1,846/2,920 Initial License: 12/30/1991

Type: Class:

MARVINS MANOR I (0012002) 603 E CLARK ST BRANDON WI 53919 (920) 346-2322 BARBARA A HENDRICKS County: FOND DU LAC MARVINS MANOR IV (0013617) 10 PLUIM DR WAUPUN WI 53963 (920) 324-9755 BARBARA HENDRICKS County: FOND DU LAC

BARBARA A HENDRICKS (920) 324-5359 BARBARA A HENDRICKS 219 FOND DU LAC ST WAUPUN WI 53963 BARBARA HENDRICKS (920) 763-3547 BARBARA HENDRICKS 10 PLUIM DR WAUPUN WI 53963

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,400/3,400 Initial License: 07/10/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 3,050/3,750 Initial License: 01/31/2011

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 34

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,080/3,955 Initial License: 05/01/1995

Type: Class:

MICHALENES (410411) 530 N UNION ST RIPON WI 54971 (920) 745-2959 CHAD LIPTOW County: FOND DU LAC PRAIRIE PLACE CBRF (0014486) 745 E OSHKOSH ST RIPON WI 54971 (920) 748-8903 BOBBI HJELMBERG County: FOND DU LAC ROBERT E BERRY HOUSE (410017) 178 SIXTH ST FOND DU LAC WI 54935 (920) 922-8580 BEVERLY GUDEX County: FOND DU LAC STERLING HOUSE OF FOND DU LAC (410459) 1001 PRIMROSE LA FOND DU LAC WI 54935 (920) 924-7775 IVORY PENNEBECKER County: FOND DU LAC TAKODAH HOUSE (410114) W5021 TAKODAH DR FOND DU LAC WI 54935 (920) 922-1232 KATHY MOORE County: FOND DU LAC TARFA TERRACE (410094) 54 W ARNDT ST FOND DU LAC WI 54935 (920) 921-9520 DEBRA BARTH County: FOND DU LAC Association Approval: Leading Age TOUCHSTONE LIVING CENTER LLC (0011312) 300 WINNEBAGO ST N FOND DU LAC WI 54937 (920) 922-7242 NANCY STEINKE County: FOND DU LAC TOWER VIEW VILLA CORP (0009774) 401 N GRANT ST ROSENDALE WI 54974 (920) 872-2550 BARBARA SULLIVAN County: FOND DU LAC WOLVERTON GLEN ASSISTED LIVING (0012057) 50 WOLVERTON AVE RIPON WI 54971 (920) 748-5638 BRUCE SCHLEI County: FOND DU LAC WOODLANDS OF FOND DU LAC LLC (0009427) 1446 LYNN AVE FOND DU LAC WI 54937 (920) 922-8770 SUE HENDRICKSON County: FOND DU LAC WOODLANDS SENIOR PARK (0010166) 77 WISCONSIN AMERICAN DR FOND DU LAC WI 54935 (920) 922-8770 SUZANNE HENDRICKSON County: FOND DU LAC WOODLANDS SENIOR PARK (0011204) 87 WISCONSIN AMERICAN DR FOND DU LAC WI 54935 (920) 273-0335 SUZANNE HENDRICKSON County: FOND DU LAC

MIDEL INC (262) 369-8342 DELBERT VANSTONE W304 N1860 MAPLE AVE PEWAUKEE WI 53072-4709 PRAIRIE ASSISTED LIVING INC (920) 748-8900 JEREMIAH GROTHE 749 E OSHKOSH ST RIPON WI 54971 ROBERT E BERRY HOUSE INC (920) 922-8580 BEVERLY GUDEX 178 SIXTH ST FOND DU LAC WI 54935 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 IVORY PENNEBECKER 1001 PRIMROSE LANE FOND DU LAC WI 54935 LIFELINE SERVICES OF FOND DU LAC INC (920) 922-4068 GEORGIANN FROEMKE 13 SIXTH ST FOND DU LAC WI 54935 FOND DU LAC LUTHERAN HOME INC DBA TAR (920) 921-9520 DEBRA BARTH 54 W ARNDT ST FOND DU LAC WI 54935 TOUCHSTONE LIVING CENTERS LLC (920) 922-7242 MARY JO HIRSCH 300 WINNEBAGO ST N FOND DU LAC WI 54937 TOWER VIEW VILLA CORP (920) 872-2378 BARBARA SULLIVAN N8149 CTH M RIPON WI 54971 ELITE SENIOR LIVING - WOLVERTON LLC (920) 748-5638 JONATHAN J HERATY 50 WOLVERTON AVE RIPON WI 54971 WOODLANDS OF FOND DU LAC LLC (920) 922-8770 SUE HENDRICKSON 77 WISCONSIN AMERICAN DR FOND DU LAC WI 54937 WOODLANDS OF FOND DU LAC LLC (920) 922-8770 SUZANNE HENDRICKSON 77 WISCONSIN AMERICAN DRIVE FOND DU LAC WI 54935 THE WOODLANDS LLC (920) 922-8770 SUE HENDRICKSON 77 WISCONSIN AMERICAN DR FOND DU LAC WI 54935

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,350/3,800 Initial License: 01/23/2013

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,268/2,511 Initial License: 11/01/1978

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,295/6,000 Initial License: 08/19/1996

Type: Class:

CBRF AS Gender - Capacity: M/F - 6 Low/High rate: 3,771/4,700 Initial License: 01/01/1988

Type: Class:

CBRF CS Gender - Capacity: M/F - 32 Low/High rate: 2,805/4,470 Initial License: 07/01/1986

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,000/4,000 Initial License: 05/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,625/3,325 Initial License: 09/12/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,400/3,000 Initial License: 08/01/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 3,300/3,625 Initial License: 11/29/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 3,200/3,500 Initial License: 09/17/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 34 Low/High rate: 3,000/3,300 Initial License: 03/07/2006

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 35

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,600/4,600 Initial License: 01/09/2013

Type: Class:

MAPLEWOOD VILLA LLC CBRF (0014330) 9343 STATE HWY 101 ARMSTRONG CREEK WI 54103 (715) 336-2044 KAREN HOFFMANN County: FOREST

MAPLEWOOD VILLA LLC (715) 336-2044 JOEL KOLL 9343 STATE HWY 101 ARMSTRONG CREEK WI 54103

BOSCOBEL VISTA (0013715) 111 VISTA PLACE BOSCOBEL WI 53805 (608) 341-8301 BERNIE BOBER County: GRANT CLA LANCASTER (110393) 1330 ARBOR OAKS LANE LANCASTER WI 53813 (608) 723-4979 JOANNE ZUTZ County: GRANT FENNIMORE COMMUNITY GOOD SAMARITAN CENTER (0 1850 11TH ST FENNIMORE WI 53809 (608) 822-6100 LAURIE KREUL County: GRANT Association Approval: Leading Age GRACIOUS WAY ASSISTED LIVING (0014079) 435 W WALNUT ST MUSCODA WI 53573 (608) 739-3450 CHASITY WALSH County: GRANT

UPLAND POINT CORPORATION (608) 341-8301 BERNIE BOBER PO BOX 110 MINERAL POINT WI 53565 COMMUNITY LIVING ARRANGEMENTS INC (262) 723-8392 JOANNE ZUTZ PO BOX 200 ELKHORN WI 53121 FENNIMORE COMMUNITY GOOD SAMARITAN C (608) 822-6100 LAURIE KREUL 1850 11TH ST FENNIMORE WI 53809 LORI KNAPP CRAWFORD INC (608) 326-5536 KELLY GOCHENAUR 106 S BEAUMONT RD PRAIRIE DU CHIEN WI 53821

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,600/5,250 Initial License: 06/07/2011

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 2,765/5,623 Initial License: 04/18/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,557/5,084 Initial License: 06/14/2001

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 4,045/6,235 Initial License: 04/19/2012

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS

Association Approval: WiCAL LYGHTHOUSE LLC (0008993) 1976 OLD LANCASTER RD PLATTEVILLE WI 53818 (608) 348-4944 ROXANNE LYGHT County: GRANT

ROXANNE LYGHT (608) 348-4944 ROXANNE LYGHT 1973 OLD LANCASTER RD PLATTEVILLE WI 53818

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,400/3,697 Initial License: 05/01/2000

Type: Class:

MORNINGSIDE ASSISTED LIVING (0009040) 850 CITY LIMITS ST LANCASTER WI 53813 (608) 723-5232 RENAE CREASEY County: GRANT

ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY GRIFFIN 1402 PANKRATZ ST SUITE 110 MADISON WI 53704

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,720/4,020 Initial License: 06/28/2000

Type: Class:

OUR HOUSE ASSISTED CARE (0013380) 1735 N WATER ST PLATTEVILLE WI 53818 (608) 348-6622 DEBRA WILSON County: GRANT PARK PLACE ASSISTED LIVING (0012395) 1015 N ELM ST PLATTEVILLE WI 53818 (608) 243-8800 ANGIE PIERCE County: GRANT

KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY GRIFFIN 1402 PANKRATZ ST STE 110 MADISON WI 53704

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,210/4,000 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,690/3,840 Initial License: 08/21/2008

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 36

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 4,440/4,590 Initial License: 11/01/2008

Type: Class:

PARK PLACE MEMORY CARE (0012396) 1155 N ELM ST PLATTEVILLE WI 53818 (608) 243-8800 ANGIE PIERCE County: GRANT

ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY GRIFFIN 1402 PANKRATZ ST STE 110 MADISON WI 53704

SIENNA CREST PLATTEVILLE (0012464) 1480 BEARS CT PLATTEVILLE WI 53818 (608) 348-6450 SUE WHITE County: GRANT CARING HANDS 2 INC (110338) 605 E 4TH AVE BRODHEAD WI 53520 (608) 897-2451 HENRY LEUENBERGER County: GREEN COLLINWOOD ELDERLY CARE (110513) 703 GREEN ST BRODHEAD WI 53520 (608) 897-8624 LOUANN HARMEL County: GREEN

SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUE WHITE 116 SPRING ST OREGON WI 53575 CARING HANDS 2 INC (608) 558-6580 HENRY LEUENBERGER 1006 21ST ST BRODHEAD WI 53520 DISCH ENTERPRISES LTD (608) 558-7290 LOUANN HARMEL N5219 CTY E ALBANY WI 53502

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,050/4,550 Initial License: 09/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 2,300/3,400 Initial License: 04/30/1992

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,700/3,500 Initial License: 05/28/1996

Type: Class:

COMMUNITY LIVING HOME OPTIONS LLC (0012717) 215 3RD ST MONROE WI 53566 (608) 329-4991 ELIZABETH FLOOD County: GREEN

(608) 214-5683 ELIZABETH FLOOD 215 3RD ST MONROE WI 53566

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,750/5,800 Initial License: 04/06/2009

Type: Class:

GRACELAND MANOR II (110515) 320 W 17TH ST MONROE WI 53566 (608) 329-7090 JODY E NEUENSCHWANDER County: GREEN GRACELAND MANOR III (111029) 316 WEST 17TH ST MONROE WI 53566 (608) 329-7150 JODY NEUENSCHWANDER County: GREEN HARBOR HOUSE MONROE 19 (0013409) 2800 6TH AVE MONROE WI 53566 (608) 329-6340 PAULETTE WILLIAMS County: GREEN HARBOR HOUSE MONROE 8 (0013408) 2810 6TH AVE MONROE WI 53566 (608) 329-6340 PAULETTE WILLIAMS County: GREEN HEARTSONG ASSISTED LIVING (0011573) 415 EAST AVE BELLEVILLE WI 53508 (608) 424-6787 JUDY JENNESS County: GREEN

GRACELAND MANOR OF MONROE LLC (608) 558-0864 JODY R NEUENSCHWANDER 320 W 17TH ST MONROE WI 53566 GRACELAND MANOR OF MONROE LLC (608) 558-0864 JODY NEUENSCHWANDER 316 WEST 17TH ST MONROE WI 53566 AZURA MONROE LLC (608) 329-6340 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562 AZURA MONROE 2 LLC (608) 329-6340 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562 DERALD JENNESS (608) 290-7346 DERALD JENNESS 5825 DAWLEY DR FITCHBURG WI 53711

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,650/3,800 Initial License: 06/30/1996

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,500/5,000 Initial License: 06/01/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,500/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,350/4,050 Initial License: 08/15/2006

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 37

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 13 Low/High rate: 1,700/2,300 Initial License: 12/31/1991

Type: Class:

MORNING SUN CARE HOME (110147) N4166 CTY E BRODHEAD WI 53520 (608) 897-8211 LINDA R KENNEDY County: GREEN VALLEY PARK (0013910) 750 CAROLAN DR ALBANY WI 53502 (608) 862-3447 LOUANN HARMEL County: GREEN

LINDA KENNEDY (608) 897-8211 LINDA R KENNEDY N4166 CTY E BRODHEAD WI 53520 DISCH ENTERPRISES LTD (608) 862-3383 LOUANN HARMEL N5219 COUNTY RD E ALBANY WI 53502

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,000 Initial License: 02/02/2012

Type: Class:

BARRETT HOUSE INC (410302) 185 E JOHN ST MARKESAN WI 53946 (920) 398-2989 BARBARA REIF County: GREEN LAKE BROWN WILCOX RETIREMENT HOME (410143) 347 E HURON ST BERLIN WI 54923 (920) 361-2552 TINA M NELSEN County: GREEN LAKE CCLS MOUND STREET (0011136) 284 MOUND ST BERLIN WI 54923 (920) 361-1366 JAN BAUMGARTNER County: GREEN LAKE CUMBERLAND HOUSE GROUP HOME (0008558) 343 E CUMBERLAND ST BERLIN WI 54923 (920) 361-0491 JAN BAUMGARTNER County: GREEN LAKE KINDREDHEARTS GREEN LAKE (0011582) 860 SUNNYSIDE RD GREEN LAKE WI 54941 (920) 294-1000 LISA NELSON County: GREEN LAKE MARTHAS INC (410197) 404 W WATER ST PRINCETON WI 54968 (920) 295-4222 MARIETTA BENTLEY County: GREEN LAKE PATRIOT PLACE CBRF (0012720) 609 BROADWAY BERLIN WI 54923 (920) 361-3007 JOSIAH GROTHE County: GREEN LAKE

BARRETT HOUSE INC (920) 394-3178 BARBARA REIF 185 E JOHN ST MARKESAN WI 53946 BROWN WILCOX TRUSTEES CO INC (920) 361-2605 PETER MAUEL PO BOX 150 BERLIN WI 54923 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 CCLS INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094-3749 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 256-0488 DEB ELLIS 850 SUNNYSIDE RD GREEN LAKE WI 54941 MARTHAS INC (920) 295-6762 MARIETTA BENTLEY 404 W WATER ST PRINCETON WI 54968 HEARTLAND PRESTON INC (920) 787-5817 JOSIAH GROTHE 668 W CUMMINGS RD WAUTOMA WI 54982

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,750/3,000 Initial License: 09/01/1992

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 1,895/2,295 Initial License: 02/01/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 4,795/4,795 Initial License: 11/22/2005

Type: Class:

CBRF AA Gender - Capacity: M - 5 Low/High rate: 3,484/3,484 Initial License: 01/01/1999

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,780/3,650 Initial License: 09/01/2006

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 1,960/3,500 Initial License: 10/13/1989

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,275/3,800 Initial License: 02/27/2009

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CORNERSTONE FOUNDATION KENZIE STREET CBRF (0 LUCKY STAR 3 CORP (608) 935-1649 201 N KENZIE ST RICK STARR BARNEVELD WI 53507 PO BOX 150 (608) 924-2611 JEAN O'NEILL DODGEVILLE WI 53533 County: IOWA

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,200/3,800 Initial License: 04/21/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 38

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

CBRF CNA Gender - Capacity: M/F - 43 Low/High rate: 3,480/3,780 Initial License: 07/20/1998

Type: Class:

Specialty Programs

CRESTRIDGE ASSISTED LIVING OF DODGEVILLE LLC (1 ELDERSPAN MANAGEMENT LLC (608) 243-8800 219 EAST GRACE ST DAVID GRIFFIN DODGEVILLE WI 53533 1402 PANKRATZ ST STE 110 (608) 935-0211 BRENDA M WELSH MADISON WI 53704 County: IOWA

PINE LAWN (0014068) 535 SPRING ST HIGHLAND WI 53543 (608) 929-7512 REBECCA BOBER County: IOWA

UPLAND POINT CORPORATION (608) 341-8301 BERNARD BOBER PO BOX 110 MINERAL POINT WI 53565

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 1,930/3,802 Initial License: 06/15/2012

Type: Class:

SIENNA CREST DODGEVILLE (0009500) 404 EAST MADISON ST DODGEVILLE WI 53533 (608) 935-9430 SUSAN WHITE County: IOWA SIENNA CREST MINERAL POINT (0008694) 210 COPPER ST MINERAL POINT WI 53565 (608) 987-4565 SUE WHITE County: IOWA UPLAND POINT (110435) 404 PINE ST MINERAL POINT WI 53565 (608) 987-4336 BERNARD BOBER County: IOWA UPLAND POINT CORPORATION SUNNYSIDE (0012225) 209 W PARRY ST DODGEVILLE WI 53533 (608) 319-2209 BERNARD P BOBER County: IOWA

SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUSAN WHITE PO BOX 45 OREGON WI 53575 SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUE WHITE PO BOX 45 OREGON WI 53575 UPLAND POINT CORPORATION (608) 987-4336 BERNARD BOBER P.O. BOX 110 MINERAL POINT WI 53565 UPLAND POINT CORPORATION (608) 341-8301 BERNARD P BOBER PO BOX 110 MINERAL POINT WI 53565

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,975/4,475 Initial License: 10/29/2001

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,200/4,700 Initial License: 08/01/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,194/6,240 Initial License: 09/14/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,457/6,938 Initial License: 02/04/2008

Type: Class:

UPLAND POINT CORPORATION SUNNYSIDE EAST (0012 UPLAND POINT CORPORATION (608) 341-7774 207 W PARRY ST BERNARD BOBER DODGEVILLE WI 53533 PO BOX 110 (608) 574-7759 BERNARD BOBER MINERAL POINT WI 53565 County: IOWA MAPLE LEAF GROUP HOME (610279) 5630 W US HWY 2 HURLEY WI 54534 (715) 561-4515 DONNA REINERIO County: IRON COUNTRY TERRACE BLACK RIVER FALLS (0010113) 525 E SECOND ST BLACK RIVER FALLS WI 54615 (715) 284-2060 NICOLE WEBER County: JACKSON HANSON HOUSE (0013867) N10599 CTY RD G OSSEO WI 54758 (715) 797-7999 KARMEN HANSON County: JACKSON PARKSIDE RESIDENCE ASSISTED LIVING (0013504) 109 N 14TH ST BLACK RIVER FALLS WI 54615 (715) 284-4397 DENA OTTO County: JACKSON HIGHLINE CORPORATION (715) 561-4515 DONNA REINERIO PO BOX 218 HURLEY WI 54534 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903-3006 KARMEN HANSON (715) 797-7999 KARMEN HANSON W15804 DEWEY RD HIXTON WI 54635 PARKSIDE RESIDENCE ASSISTED LIVING LLC (715) 284-4397 DENA OTTO 109 N 14TH ST BLACK RIVER FALLS WI 54615

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,619/5,281 Initial License: 11/01/2009

Type: Class:

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 1,867/1,867 Initial License: 02/28/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,600/4,100 Initial License: 01/21/2003

Type: Class:

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 3,000/4,500 Initial License: 10/24/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 2,526/3,410 Initial License: 12/13/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 39

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 9 Low/High rate: 950/1,500 Initial License: 11/04/1996

Type: Class:

RJS CARE HOME LLC (510349) N7525 COUNTY RD A HIXTON WI 54635 (715) 284-0094 JILL LABAR County: JACKSON WAZEE HOUSE (510066) N5488 HWY 54 W BLACK RIVER FALLS WI 54615 (715) 284-4987 JEFFREY KNUDSON County: JACKSON APPLE HOUSE (0012615) 1621 PREMIER PL FORT ATKINSON WI 53538 (920) 563-5723 SARA FOERSTER County: JEFFERSON AUTUMN WINDS OF OAKLAND LLC (0009237) N3767 AIRPORT RD CAMBRIDGE WI 53523 (608) 423-9300 PENNY GODFREY GRAFF County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES - EAST HAVEN (00 208 EAST HAVEN WATERTOWN WI 53094 (920) 206-9363 SHERENA BIRKHOLZ County: JEFFERSON

RJS CARE HOME LLC (715) 963-5313 ROY & JILL LABAR N7525 COUNTY RD A HIXTON WI 54635 LUTHERAN SOC SERV OF WI & UPPER MI INC (715) 834-2046 JEFFREY KNUDSON N5488 HWY 54W BLACK RIVER FALLS WI 54615 HOMES FOR INDEPENDENT LIVING OF WI INC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 PENNY GODFREY GRAFF (608) 423-9300 PENNY GODFREY GRAFF N3767 AIRPORT RD CAMBRIDGE WI 53523 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DRIVE WATERTOWN WI 53094

ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,129/2,129 Initial License: 02/01/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,900/4,900 Initial License: 01/30/2009

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 2,500/5,259 Initial License: 03/06/2001

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,117/6,117 Initial License: 04/02/2002

Type: Class:

BETHESDA LUTHERAN COMMUNITIES - HYER (0010707) BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 411 HYER DR GRETCHEN BLOCK JEFFERSON WI 53549 700 HOFFMANN DR (920) 674-3060 KATHY HOEFLER WATERTOWN WI 53094 County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES - MADISON (0010 968 E MADISON ST WATERLOO WI 53594 (920) 478-2994 ROB SERVAIS County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES - MICHELLE (0010 141 MICHELLE DR JOHNSON CREEK WI 53038 (920) 699-3117 GEMMA GIUNTA County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES - MONROE (00107 734 N MONROE ST WATERLOO WI 53594 (920) 478-9666 ROBERT SERVAIS County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES MARK (0010058) 140 MARK DR JOHNSON CREEK WI 53038 (920) 699-3115 GEMMA GIUNTA County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES WAKOKA I (00108 1316/1318 WAKOKA ST WATERTOWN WI 53094 (920) 264-7579 LINDSAY PROBST County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES WAKOKA II (0010 1320/1322 WAKOKA ST WATERTOWN WI 53094 (920) 261-9917 LINDSAY KIRCHOFF County: JEFFERSON BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMANN DR WATERTOWN WI 53094

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,734/5,734 Initial License: 11/05/2004

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,507/4,507 Initial License: 11/01/2004

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,942/4,942 Initial License: 05/27/2003

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,496/5,496 Initial License: 11/01/2004

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,288/5,288 Initial License: 05/27/2003

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,995/5,995 Initial License: 01/20/2005

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,586/5,586 Initial License: 11/14/2005

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 40

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,631/4,700 Initial License: 12/15/1994

Type: Class:

BIRCH TERRACE (310314) 1109 CASWELL ST FORT ATKINSON WI 53538 (920) 568-4509 TYLER HANSEN County: JEFFERSON

ABILITIES INC (920) 563-8554 CHRISTINE KLITZKIE PO BOX 84 FORT ATKINSON WI 53538

BLACK HAWK SENIOR RESIDENCE (0014288) 1 MILWAUKEE AVE WEST FORT ATKINSON WI 53538 (920) 563-1480 PAUL ANDREW LOGAN County: JEFFERSON BROOK GARDENS ASSISTED LIVING (0011383) 300 O'NEIL ST LAKE MILLS WI 53551 (920) 648-5760 JOLENE LUCAS County: JEFFERSON CEDAR HILL (310332) N1366 HWY 12 FORT ATKINSON WI 53538 (920) 563-4869 TYLER HANSEN County: JEFFERSON COMMONWEALTH HOME (0011559) 1501 COMMONWEALTH DR FORT ATKINSON WI 53538 (920) 563-3245 TAMI RICH County: JEFFERSON DOHERTY HOME (0011631) N7855 LITTLE COFFEE RD WATERTOWN WI 53094 (920) 206-9034 MARGUERITE RUPNOW County: JEFFERSON EAGLE VIEW MANOR (0012305) 881 COLLINS RD JEFFERSON WI 53549 (920) 674-2260 JILL JOHNSON County: JEFFERSON

BLACK HAWK RESIDENTIAL OPERATIONS LLC (920) 563-1480 P ANDREW LOGAN 1 MILWAUKEE AVE WEST FORT ATKINSON WI 53538 ALC OPERATING LLC (262) 257-8888 MARY ZAK-KOWALCZYK W140 N8981 LILLY RD MENOMONEE FALLS WI 53051 ABILITIES INC (920) 563-8554 CHRISTINE KLITZKIE PO BOX 84 FORT ATKINSON WI 53538 HOMES FOR INDEPENDENT LIVING OF WISCON (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 PRADER WILLI HOMES OF OCONOMOWOC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 CRU GROUP HOME INC (414) 351-5430 JILL JOHNSON 881 COLLINS RD JEFFERSON WI 53549

CBRF CNA Gender - Capacity: M/F - 38 Low/High rate: 2,600/4,800 Initial License: 10/03/2012

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 3,360/3,810 Initial License: 04/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,513/6,992 Initial License: 02/15/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 5,665/5,665 Initial License: 08/09/2006

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 8,175/8,175 Initial License: 10/02/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,950/5,000 Initial License: 05/01/2008

Type: Class:

FALCONS NEST CBRF (0012983) 160 W BLACKHAWK DR FORT ATKINSON WI 53538 (920) 563-8554 TYLER HANSEN County: JEFFERSON GOLDEN EAGLE CBRF (0012778) 216 W BLACKHAWK DR FORT ATKINSON WI 53538 (920) 397-7292 TYLER D HANSEN County: JEFFERSON

ABILITIES INC (920) 563-8554 TYLER HANSEN PO BOX 84 FORT ATKINSON WI 53538 ABILITIES INC (920) 563-8554 TYLER D HANSEN PO BOX 84 FORT ATKINSON WI 53538

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,900/4,800 Initial License: 11/17/2009

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 4,687/6,675 Initial License: 06/15/2009

Type: Class:

HIL LINDEN CORNER (0009792) 325 W BLACKHAWK DR FORT ATKINSON WI 53538 (920) 563-4783 SARA FOERSTER County: JEFFERSON

HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 6,653/6,653 Initial License: 01/01/2002

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 41

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 7,307/7,307 Initial License: 01/01/2002

Type: Class:

HIL SANDSTONE (0009793) 1533 S MAIN ST FORT ATKINSON WI 53538 (920) 563-5134 SARA FOERSTER County: JEFFERSON HIL WILLOW COURT (0009795) 575 BLACKHAWK DR FORT ATKINSON WI 53538 (920) 568-1519 BEN PRIESGEN County: JEFFERSON LONDON LODGE I (310455) W9095 LONDON RD CAMBRIDGE WI 53523 (920) 648-3171 MARGARET PENNEWELL County: JEFFERSON LONDON LODGE II (310717) W9097 LONDON RD CAMBRIDGE WI 53523 (920) 648-2309 MARGARET PENNEWELL County: JEFFERSON LUEDER HAUS (310460) 1473 ANNEX RD JEFFERSON WI 53549 (920) 674-8114 TERRI JURCZYK County: JEFFERSON MAPLE RUN CBRF (0012086) N2489 WENHAM RD FORT ATKINSON WI 53538 (920) 568-0413 TYLER HANSEN County: JEFFERSON MARGARET RUTH HOME (310407) N8007 LAKEVIEW DR TOWN OF IXONIA WI 53036 (262) 569-5533 HOLLIE BALLARD County: JEFFERSON OAK GROVE CBRF (0013156) W3343 HOFFMAN RD FORT ATKINSON WI 53538 (262) 593-5508 CHRISTINE KLITZKIE County: JEFFERSON REM WISCONSIN II DOMMO DRIVE (0010047) 1501 DOMMO DR FORT ATKINSON WI 53538 (920) 568-4526 JULIE CHAMPION County: JEFFERSON REM WISCONSIN II STACY LANE (0010048) 1403 STACY LN FORT ATKINSON WI 53538 (920) 568-4533 JULIE CHAMPION County: JEFFERSON RIVER VIEW (0013066) 740 N FREMONT ST WHITEWATER WI 53190 (262) 473-0490 NANCY SCHNEIDER County: JEFFERSON

HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 LONDON LODGE INC (920) 648-3171 MARGARET PENNEWELL W9095 LONDON RD CAMBRIDGE WI 53523 LONDON LODGE INC (920) 648-3171 MARGARET PENNEWELL W9095 LONDON RD CAMBRIDGE WI 53523 JEFFERSON COUNTY HUMAN SERVICES DEPT (920) 674-3105 TERRI JURCZYK 1473 ANNEX RD JEFFERSON WI 53549 ABILITIES INC (920) 563-8554 TYLER HANSEN PO BOX 84 FORT ATKINSON WI 53538 PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 ABILITIES INC (920) 563-8554 CHRISTINE KLITZKIE PO BOX 84 FORT ATKINSON WI 53538 REM WISCONSIN II INC (608) 276-1192 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 REM WISCONSIN II INC (608) 276-1192 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,236/6,236 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,332/3,995 Initial License: 01/09/1996

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 3,000/4,650 Initial License: 10/16/1998

Type: Class: Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,897/4,897 Initial License: 07/31/1995 CBRF CS Gender - Capacity: M - 6 Low/High rate: 4,079/6,118 Initial License: 10/11/2007

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 8,224/8,224 Initial License: 02/01/1990

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,843/7,500 Initial License: 03/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,567/5,841 Initial License: 05/28/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,347/5,870 Initial License: 05/28/2003

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,400/5,832 Initial License: 01/01/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 42

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 7 Low/High rate: 5,054/5,353 Initial License: 01/01/2010

Type: Class:

ROLLING MEADOWS (0013071) N464 POEPPEL RD FORT ATKINSON WI 53538 (920) 563-9075 NANCY SCHNEIDER County: JEFFERSON

BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

SHADY ACRES CBRF (0012558) N5015 HWY Y JEFFERSON WI 53549 (920) 674-5015 TYLER HANSEN County: JEFFERSON SIENNA CREST FORT ATKINSON (310733) 1531 COMMONWEALTH DR FORT ATKINSON WI 53538 (920) 568-1840 SUE WHITE County: JEFFERSON ST COLETTA OF WI DOWER CBRF (0013042) 528 S KRANZ AVE JEFFERSON WI 53549 (920) 675-1616 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI JACOBA (0012782) 640 E THEODORE ST JEFFERSON WI 53549 (920) 674-2715 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI LOURDES (310538) 140 S KRANZ AVE JEFFERSON WI 53549 (920) 674-6399 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI LUCHENBACH (0012785) 648 E LUCHENBACH LN JEFFERSON WI 53549 (920) 674-4361 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI PADUA HEIGHTS (0009098) 724 E RACINE ST JEFFERSON WI 53549 (920) 675-1610 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI SAN DAMIANO (310540) 128 S KRANZ AVE JEFFERSON WI 53549 (920) 674-6485 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI ST AGNES (310542) 900 E RACINE ST JEFFERSON WI 53549 (920) 674-6530 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI ST ISIDORE (310548) 124 ORCHARD VIEW COURT JEFFERSON WI 53549 (920) 675-1603 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI ST JOHN THE BAPTIST (310549) W5078 HWY 18 JEFFERSON WI 53549 (920) 675-1605 ELIZABETH BRZESKI County: JEFFERSON

ABILITIES INC (920) 563-8554 TYLER HANSEN PO BOX 84 FORT ATKINSON WI 53538 SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUE WHITE PO BOX 45 OREGON WI 53575 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY S LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN (920) 674-4330 ANTHONY S LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY S LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY S LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 4,513/8,266 Initial License: 11/10/2008

Type: Class:

ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,700/4,900 Initial License: 01/01/1999

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 4,380/5,912 Initial License: 12/11/2009

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: F - 5 Low/High rate: 5,211/5,211 Initial License: 05/04/2009 CBRF CS Gender - Capacity: F - 8 Low/High rate: 2,542/5,199 Initial License: 09/01/1985

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M - 5 Low/High rate: 5,797/6,016 Initial License: 05/15/2009

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 937/4,304 Initial License: 07/10/2000

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: F - 8 Low/High rate: 2,697/4,771 Initial License: 06/02/1985

Type: Class:

CBRF AS Gender - Capacity: F - 8 Low/High rate: 2,990/2,990 Initial License: 08/31/1993

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF AS Gender - Capacity: M - 10 Low/High rate: 1,850/3,775 Initial License: 06/01/1987

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AS Gender - Capacity: M - 8 Low/High rate: 3,457/5,536 Initial License: 05/11/1992

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 43

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: F - 8 Low/High rate: 3,751/5,038 Initial License: 09/01/1980

Type: Class:

ST COLETTA OF WI ST MARTHA (310546) W5092 HWY 18 JEFFERSON WI 53549 (920) 674-6531 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI ST MICHAEL (310551) 822 E RACINE ST JEFFERSON WI 53549 (920) 674-6860 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI TAU (0012786) 621 E SPRING ST JEFFERSON WI 53549 (920) 674-2849 ELIZABETH BRZESKI County: JEFFERSON ST COLETTA OF WI THEODORE (0012784) 621 E THEODORE ST JEFFERSON WI 53549 (920) 674-4490 ELIZABETH BRZESKI County: JEFFERSON STEPPING STONE CBRF (0012335) 318 N MAIN ST FORT ATKINSON WI 53538 (920) 563-7914 TYLER HANSEN County: JEFFERSON STRAWBERRY HILL (0013074) N556 HOWARD RD WHITEWATER WI 53190 (262) 473-0483 NANCY SCHNEIDER County: JEFFERSON SUNSET RIDGE ASSISTED LIVING (0013538) 1275 REMMEL DRIVE JOHNSON CREEK WI 53038 (920) 699-1275 BARBARA MACK County: JEFFERSON SYLVAN CROSSINGS OF JEFFERSON (310666) 279 N JACKSON AVE JEFFERSON WI 53549 (920) 674-0698 DAWN KOCH County: JEFFERSON WELLINGTON MEADOWS (0012024) N2550 MEMORIAL DR FORT ATKINSON WI 53538 (920) 563-2199 ASHLEY KRUEGER County: JEFFERSON WELLINGTON PLACE OF FORT ATKINSON (0012025) 200 S WATER ST WEST FORT ATKINSON WI 53538 (920) 563-6959 NICOLE HAYES County: JEFFERSON COTTAGE CARE CENTER (0010835) 204 HALL ST MAUSTON WI 53948 (608) 847-7470 DARLENE J SEEVER County: JUNEAU

ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN (920) 674-4330 ANTHONY LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ST COLETTA OF WISCONSIN INC (920) 674-4330 ANTHONY S LODUCA N4637 CTY HWY Y JEFFERSON WI 53549-9720 ABILITIES INC (920) 563-8554 TYLER HANSEN PO BOX 84 FORT ATKINSON WI 53538 BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190 JAMES KUEHN (920) 265-8761 JAMES KUEHN PO BOX 560 JOHNSON CREEK WI 53038 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 WELLINGTON HOMES OF WI LLC (703) 868-0503 ASHLEY KRUEGER N2550 MEMORIAL DR FORT ATKINSON WI 53538 WELLINGTON HOMES OF WI LLC (703) 868-0503 NICOLE HAYES 200 S WATER ST WEST FORT ATKINSON WI 53538 DARLENE J SEEVER (608) 548-3208 DARLENE J SEEVER 204 HALL ST MAUSTON WI 53948

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M - 8 Low/High rate: 2,621/3,948 Initial License: 10/01/1985

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: F - 5 Low/High rate: 5,955/6,174 Initial License: 05/12/2009

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M - 5 Low/High rate: 3,935/3,935 Initial License: 05/04/2009

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,300/5,000 Initial License: 05/15/2008

Type: Class:

Gender - Capacity:

CBRF AA M/F - 6 Low/High rate: 5,215/5,741 Initial License: 01/01/2010

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,500/4,300 Initial License: 01/11/2011 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,300/4,560 Initial License: 11/11/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 3,156/4,156 Initial License: 09/01/2007

Type: Class:

ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,083/3,982 Initial License: 09/07/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,100/3,500 Initial License: 02/02/2005

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 44

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,195/3,195 Initial License: 12/02/2009

Type: Class:

COTTAGE CARE CIRCLE (0013060) 320 ATTEWELL STREET MAUSTON WI 53948 (608) 847-6248 DARLENE SEEVER County: JUNEAU

DARLENE SEEVER (608) 847-7470 DARLENE SEEVER 204 HALL STREET MAUSTON WI 53948

CREST VIEW GREAT LAKES (0009594) 612 VIEW ST NEW LISBON WI 53950 (608) 562-3667 JENNIFER BRANDAU County: JUNEAU EVERGREEN MANOR INC (0010512) W5205 BUCKEYE DR NECEDAH WI 54646 (608) 565-2522 JIM ROSIN County: JUNEAU OAK RUN (110465) N9895 18TH AVE PO BOX 40 NECEDAH WI 54646 (608) 565-3700 BRENDA FALK-HUZAR County: JUNEAU WEBER HAUS (110115) 312 CENTER ST WONEWOC WI 53968-9224 (608) 464-7688 DONNA L WEBER County: JUNEAU ADVOCATE HOMES LLC (0012373) 6555 PERSHING BLVD KENOSHA WI 53142 (262) 652-3536 SHERI BLAA County: KENOSHA ASPEN HOME (0013568) 6225 91ST AVE KENOSHA WI 53142 (262) 764-9712 STEVE KOELLNER County: KENOSHA BIRCH HOME (0012773) 1549 25TH AVE KENOSHA WI 53140 (262) 764-2582 MACK CRABTREE County: KENOSHA CANTERBURY HOME OF KENOSHA (0008960) 7924 36TH AVE KENOSHA WI 53142 (262) 697-7711 DONALD BODEL County: KENOSHA CARALOTT INC (0013431) 4901 56TH ST KENOSHA WI 53144 (262) 653-0980 RICHARD RUSKELL County: KENOSHA CAREY MANOR (310323) 10628 22ND AVE PLEASANT PRAIRIE WI 53158 (262) 694-7019 BRENDA CAREY MIELKE County: KENOSHA

MILE BLUFF MEDICAL CENTER INC (608) 562-3667 JENNIFER BRANDAU 612 VIEW ST NEW LISBON WI 53950 JIM & LARENDA ROSIN (920) 229-3664 LARENDA ROSIN PO BOX 506 SPARTA WI 54656 DEERPATH ESTATES INC (608) 565-3700 BRENDA FALK-HUZAR N9895 18TH AVE PO BOX 40 NECEDAH WI 54646 DONNA L WEBER (608) 464-7688 DONNA L WEBER 515 CENTER ST PO BOX 276 WONEWOC WI 53968-9224 ADVOCATE HOMES LLC (847) 565-2522 SHERI BLAA 755 DARNELL LN GURNEE IL 60031 CRABTREE RESIDENTIAL LIVING (262) 653-9923 JEFFREY CRABTREE P O BOX 580393 KENOSHA WI 53142 CRABTREE RESIDENTIAL LIVING INC (262) 909-4344 JEFFREY CRABTREE PO BO 580393 PLEASANT PRAIRIE WI 53158 CANTERBURY LLC (847) 656-8781 DONALD BODEL 827 TURNBERRY LN NORTHBROOK IL 60062 CARALOTT INC (262) 653-0980 RICHARD F RUSKELL 4901 56TH ST KENOSHA WI 53144 SOUTHERN WISCONSIN HOUSING SERVICES I (262) 694-3572 BRENDA CAREY MIELKE PO BOX 1349 KENOSHA WI 53141

Gender - Capacity:

CBRF CNA M/F - 12 Low/High rate: 2,585/2,890 Initial License: 04/18/2002

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 15 Low/High rate: 2,283/4,500 Initial License: 04/08/2004

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 4,095/4,664 Initial License: 02/13/1995

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 1,700/2,200 Initial License: 04/30/1985

Type: Class: Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,665/4,800 Initial License: 05/08/2008 CBRF AA Gender - Capacity: M - 6 Low/High rate: 4,600/4,600 Initial License: 11/30/2010

Type: Class:

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 4,600/4,600 Initial License: 07/27/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,000/3,600 Initial License: 06/30/2000

Type: Class:

CBRF AA Gender - Capacity: M - 5 Low/High rate: 2,800/3,500 Initial License: 07/11/2011

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,945/3,600 Initial License: 12/01/1994

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 45

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

CBRF ST. CATHERINE COMMONS II LLC C/O JAMES A T CNA (262) 798-1224 Gender - Capacity: M/F - 27 GLEN CHOBAN Low/High rate: 5,200/6,700 20711 WATERTOWN RD SUITE A Initial License: 03/05/2012 WAUKESHA WI 53186

Type: Class:

Specialty Programs

CASA DEL MARE (0014016) 3508 7TH AVE KENOSHA WI 53140 (262) 654-6080 ANDY LANGE County: KENOSHA CHRISTOPHER HOUSE (310344) 8322 14TH AVE KENOSHA WI 53143 (262) 652-8868 CARLA NICOLAUS County: KENOSHA CLARE BRIDGE OF KENOSHA (0008939) 10108 74TH ST KENOSHA WI 53142 (262) 694-6101 RYAN WALSH County: KENOSHA COLUMBUS HOUSE (310440) 2210 55TH ST KENOSHA WI 53140 (262) 656-1869 LOLITA MOODY County: KENOSHA COTTONWOOD (0013123) 5415 ADAMS RD KENOSHA WI 53144 (262) 652-9724 DUSTIN KLUCK County: KENOSHA DAYTON RESIDENTIAL CARE (310362) 521 59TH ST KENOSHA WI 53140 (262) 657-6121 LEE HAMDIA County: KENOSHA EDWARDS HOUSE (310433) 4831 47TH AVE KENOSHA WI 53144 (262) 654-3475 JESSICA WILDE County: KENOSHA

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

VOLUNTEERS OF AMERICA WISCONSIN (414) 847-1515 ANNE FOERSTER 1661 N WATER ST STE 401 MILWAUKEE WI 53202 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 RYAN WALSH 7377 88TH AVE KENOSHA WI 53142 KENOSHA HUMAN DEVELOPMENT SERVICES I (262) 657-7188 JEANNINE FIELD 5407 8TH AVE KENOSHA WI 53140 BROTOLOC SOUTH INC (262) 473-0480 SUE MILLARD 6103 39TH AVE KENOSHA WI 53142 HAMDIA LTD (262) 657-6121 LEE HAMDIA 521 59TH ST KENOSHA WI 53140 VOLUNTEERS OF AMERICA WISCONSIN (414) 847-1515 ANNE FOERSTER 1661 N WATER ST STE 401 MILWAUKEE WI 53202

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,753/4,563 Initial License: 07/01/1991

Type: Class:

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 3,505/4,375 Initial License: 08/01/2000

Type: Class:

ADVANCED AGED CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M - 14 Low/High rate: 2,028/2,028 Initial License: 05/01/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,193/5,193 Initial License: 02/05/2010

Type: Class:

CBRF CS Gender - Capacity: M/F - 90 Low/High rate: 2,109/2,673 Initial License: 04/30/1989

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,620/5,394 Initial License: 05/01/1987

Type: Class:

GENESIS OPTIONS RESIDENTIAL PROGRAM (0008832) 6755 14TH AVE KENOSHA WI 53140 (262) 654-0638 PAULINE ORTLOFF County: KENOSHA HARBOR HOUSE KENOSHA NORTH (0013412) 4600 52ND AVE KENOSHA WI 53144 (262) 654-5183 CANDACE GILLESPIE County: KENOSHA HARBOR HOUSE KENOSHA SOUTH (0013411) 7135 GREEN BAY RD KENOSHA WI 53142 (262) 942-0985 TERRI JOCHMANN-LEONARD County: KENOSHA HARBOUR VILLAGE EAST (0013121) 1130 82ND ST KENOSHA WI 53143 (262) 652-1925 DUSTIN KLUCK County: KENOSHA

GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST #2210 WEST ALLIS WI 53214 AZURA KENOSHA NORTH LLC (262) 654-5183 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 AZURA KENOSHA SOUTH LLC (262) 942-0985 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 BROTOLOC SOUTH INC (262) 473-0480 DUSTIN KLUCK 6103 39TH AVE KENOSHA WI 53142

CBRF AA Gender - Capacity: M - 20 Low/High rate: 2,067/2,067 Initial License: 11/01/1999

Type: Class:

ADVANCED AGED CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,256/4,256 Initial License: 02/05/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 46

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,802/5,802 Initial License: 02/05/2010

Type: Class:

HARBOUR VILLAGE WEST (0013120) 1150 82ND ST KENOSHA WI 53142 (262) 653-0842 DUSTIN KLUCK County: KENOSHA HARMONY OF KENOSHA (0008669) 3109 30TH AVE KENOSHA WI 53140 (262) 656-1795 JOANN VINES County: KENOSHA Association Approval: WiCAL HOME INSPIRED SENIOR LIVING (0014040) 1201 VILLAGE CENTRE DR KENOSHA WI 53144 (262) 859-2500 KEVIN METZ County: KENOSHA KARE CENTER (310442) 510 60TH ST KENOSHA WI 53140 (262) 654-3586 KARI FOSS County: KENOSHA LINDEN HOME (0012809) 3216 29TH ST KENOSHA WI 53140 (262) 551-8291 MACK CRABTREE County: KENOSHA LIVING HOPE (0008804) 1213 W MAIN ST TWIN LAKES WI 53181 (262) 877-8441 DAVID DEIHS County: KENOSHA OPEN ARMS CBRF LLC (0011480) 2217 56TH ST KENOSHA WI 53140 (262) 652-0761 RUTH GRANGER County: KENOSHA PARKSIDE MANOR (0012583) 6300 67TH ST KENOSHA WI 53142 (262) 657-7010 TREVOR CARRIVEAU County: KENOSHA RAVENSWOOD (0013122) 2615 45TH AVE KENOSHA WI 53144 (262) 553-9892 DUSTIN KLUCK County: KENOSHA SOUTH WINDS (0011693) 6305 7TH AVE KENOSHA WI 53143 (262) 564-8241 DAN HOECHERL County: KENOSHA

BROTOLOC SOUTH INC (262) 473-0480 DUSTIN KLUCK 6103 39TH AVE KENOSHA WI 53142 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE STE101 MENOMONEE FALLS WI 53051 METZ MEDICAL INC (262) 654-4000 KEVIN METZ 4720 GREEN BAY RD KENOSHA WI 53144 KENOSHA HUMAN DEVELOPMENT SERVICES I (262) 657-7188 LESTER WRIGHT 5407 8TH AVE KENOSHA WI 53140 CRABTREE RESIDENTIAL LIVING INC (262) 909-4344 JEFFREY CRABTREE PO BOX 580393 PLEASANT PRAIRIE WI 53158 LIVING HOPE LLC (262) 742-4930 DAVID DEIHS W5140 COUNTY RD A ELKHORN WI 53121 OPEN ARMS CBRF LLC (262) 764-4131 RUTH GRANGER 2217 56TH ST KENOSHA WI 53140 KENOSHA CRL LLC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVE STE 3740 CHICAGO IL 60611 BROTOLOC SOUTH INC (262) 473-0480 SUE MILLARD 6103 39TH AVE KENOSHA WI 53142 LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151-9240

CBRF CNA Gender - Capacity: M/F - 41 Low/High rate: 2,395/4,800 Initial License: 06/28/1999

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 4,000/4,000 Initial License: 04/19/2012

Type: Class:

ADVANCED AGED

CBRF AA Gender - Capacity: M/F - 12 Low/High rate: 8,466/8,466 Initial License: 02/10/1992

Type: Class:

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 6 Low/High rate: 4,600/4,600 Initial License: 07/27/2009

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 1,800/4,700 Initial License: 10/06/1999

Type: Class:

CBRF AA Gender - Capacity: M/F - 15 Low/High rate: 895/3,300 Initial License: 04/02/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 74 Low/High rate: 4,000/5,000 Initial License: 11/10/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 5,370/5,370 Initial License: 02/05/2010

Type: Class:

CBRF CS Gender - Capacity: M/F - 18 Low/High rate: 2,561/2,561 Initial License: 12/11/2006

Type: Class:

ST JAMES MANOR (0012920) 910 59TH ST KENOSHA WI 53140 (262) 656-0822 NICHOLE WRIGHT County: KENOSHA

NICHOLE WRIGHT (262) 656-0822 NICHOLE WRIGHT P O BOX 2289 KENOSHA WI 53141

CBRF AA Gender - Capacity: M/F - 16 Low/High rate: 1,750/2,250 Initial License: 07/26/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 47

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,865/2,865 Initial License: 07/16/1997

Type: Class:

STERLING HOUSE OF KENOSHA (310652) 3109 12TH ST KENOSHA WI 53144 (262) 553-1270 TONIA HUDSON County: KENOSHA SYCAMORE HOME (0012772) 9211 66TH ST KENOSHA WI 53142 (262) 653-9927 MACK CRABTREE County: KENOSHA TRANSITION HOUSE I (310566) 6024 18TH AVE KENOSHA WI 53140 (262) 658-1262 KATHY PASTERSKI County: KENOSHA TRANSITION HOUSE II (310567) 5905 19TH AVE KENOSHA WI 53140 (262) 656-1118 RENEE RASMUSON County: KENOSHA TRANSITIONAL LIVING (310568) 1834 60TH ST KENOSHA WI 53140 (262) 656-1818 EARL HAWLEY County: KENOSHA WINDY OAKS (310586) 11831 120TH CT PLEASANT PRAIRIE WI 53158 (262) 818-0002 VERA MARTIN County: KENOSHA WYNWOOD OF KENOSHA (0008601) 7377 88TH AVE KENOSHA WI 53142 (262) 697-7778 CARRIE COOPER County: KENOSHA BAY ROAD PLACE (0008556) 500 E BAY RD ALGOMA WI 54201 (920) 487-5500 MARILYN WIERER County: KEWAUNEE EMERALD SHORES ASSISTED LIVING LLC (0011751) 1100 BAUMEISTER DR KEWAUNEE WI 54216 (920) 388-2833 BARBARA BITTNER County: KEWAUNEE FRED & MAMIES HOME INC (0010798) 143 SCHOOL CREEK TRAIL LUXEMBURG WI 54217 (920) 845-5950 BARB BARBIAUX County: KEWAUNEE LINDEN MANOR (410404) 1204 FOURTH ST KEWAUNEE WI 54216 (920) 388-0110 KENNETH SECOR County: KEWAUNEE

BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5054 TONIA HUDSON 3109 12TH ST KENOSHA WI 53144 CRABTREE RESIDENTIAL LIVING INC (262) 909-4344 JEFFREY CRABTREE PO BOX 580393 PLEASANT PRAIRIE WI 53158 TRANS CORPORATION (262) 656-1818 EARL HAWLEY 1834 60TH ST KENOSHA WI 53140 TRANS CORPORATION (262) 656-1818 EARL HAWLEY 1834 60TH ST KENOSHA WI 53140 TRANS CORPORATION (262) 656-1818 EARL HAWLEY 1834 60TH ST KENOSHA WI 53140 VERA MARTIN (262) 818-0002 CRAIG MARTIN 11831 120TH CT PLEASANT PRAIRIE WI 53158 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 CARRIE COOPER 7377 88TH AVE KENOSHA WI 53142 BAY ROAD INC (920) 487-5500 GEORGE JAEGERS 500 E BAY RD ALGOMA WI 54201 EMERALD SHORES ASSISTED LIVING LLC (920) 574-3833 KATHERINE TEGEN 3232 N BALLARD RD STE 202 APPLETON WI 54911 FRED & MAMIES HOME INC (920) 845-5950 SHARON DEPEAU 143 SCHOOL CREEK TRAIL LUXEMBURG WI 54217 SECOR (920) 837-2880 KENNETH SECOR 1204 FOURTH ST KEWAUNEE WI 54216

ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 4,600/4,600 Initial License: 07/27/2009

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 21 Low/High rate: 2,300/2,300 Initial License: 02/01/1980

Type: Class:

CBRF AA Gender - Capacity: M/F - 20 Low/High rate: 2,270/2,270 Initial License: 01/01/1985

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,100/2,200 Initial License: 08/01/1988

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 8 Low/High rate: 2,600/3,625 Initial License: 06/01/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 53 Low/High rate: 35,035/40,075 Initial License: 05/10/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 2,100/3,050 Initial License: 03/15/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,823/4,060 Initial License: 02/01/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,100/5,000 Initial License: 03/07/2005

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,610/3,550 Initial License: 01/15/1995

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 48

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,150/3,600 Initial License: 07/01/2006

Type: Class:

OAK CREEK ASSISTED LIVING (0011413) 409 THIRD ST LUXEMBURG WI 54217 (920) 845-5835 MARIE PINCHART County: KEWAUNEE PINE TREE CBRF (0012647) 324 ROBIN LN LUXEMBURG WI 54217 (920) 845-5085 RANDALL VAN PAY County: KEWAUNEE SILVER LEAF MANOR (410310) 1310 LINCOLN ST KEWAUNEE WI 54216 (920) 388-2204 KENNETH SECOR County: KEWAUNEE BETHANY HEARTEN HOUSE I (510185) 2573 S 7TH ST LACROSSE WI 54601 (608) 784-4521 MARY LOU SHANKLIN County: LACROSSE Association Approval: Leading Age BETHANY HEARTEN HOUSE II (510239) 2571 S 7TH STREET LACROSSE WI 54601 (608) 784-4523 SHARON SUVOROV County: LACROSSE Association Approval: Leading Age BETHANY HEARTEN HOUSE III (510260) 101 JUNIPER LANE HOLMEN WI 54636 (608) 526-6796 TERESA MEARS County: LACROSSE Association Approval: Leading Age BLUFFVIEW MEMORY CARE (0014267) 2101 BLUFFVIEW CT HOLMEN WI 54636 (877) 306-0051 KRISTINE STEGEMEYER County: LACROSSE BRUNK HOUSE (510294) 2734 HARVEY STREET LACROSSE WI 54603 (608) 781-8706 BRIDGET TODD County: LACROSSE CARE CENTER (0013220) 4647 MORMON COULEE RD LACROSSE WI 54601 (608) 519-3080 JESSICA ECKER County: LACROSSE CHILEDA (0011556) 1825 VICTORY STREET LACROSSE WI 54601-7299 (608) 782-6480 RUTH WISEMAN County: LACROSSE CLADDAGH HOUSE-FARNAM (0010114) 1301 S 28TH ST LACROSSE WI 54601 (608) 787-8094 CARMEL LEDEBUHR County: LACROSSE

P & J OAKS LLC (920) 755-4300 PAM ROSSANO 409 THIRD ST LUXEMBURG WI 54217 INFINITY CARE INC (920) 845-5085 RANDALL VAN PAY 324 ROBIN LN LUXEMBURG WI 54217 SECOR (920) 388-2204 KENNETH/MARILYN SECOR 1310 LINCOLN ST KEWAUNEE WI 54216 BETHANY LUTHERAN HOMES INC (608) 775-8292 DONNA MILLER 2575 S 7TH ST LACROSSE WI 54601 BETHANY LUTHERAN HOMES INC (608) 775-8292 DONNA MILLER 2575 S 7TH STREET LACROSSE WI 54601 BETHANY LUTHERAN HOMES INC (608) 775-8292 DONNA MILLER 2575 S 7TH ST LACROSSE WI 54601 HOLMEN ASSISTED LIVING PARTNERS LLC (715) 864-1258 KATIE KUESTER 2101 BLUFFVIEW CT HOLMEN WI 54636 ATTIC CORRECTIONAL SERVICES INC (608) 223-0017 KATHY JOHNSON 107 4TH ST BARABOO WI 53913-2148 KEVIN FLOREK (877) 661-9051 VICKI RILEY 4647 MORMON COULEE RD LACROSSE WI 54601 CHILEDA INSTITUTE INC (608) 782-6480 RUTH WISEMAN 1825 VICTORY ST LACROSSE WI 54601-7299 CLADDAGH HOUSE INC (507) 895-6447 CARMEL LEDEBUHR 333 S 2ND ST LA CRESCENT MN 55947

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,229/5,229 Initial License: 12/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF ANA Gender - Capacity: M/F - 8 Low/High rate: 2,490/3,110 Initial License: 10/09/1992

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,750/4,080 Initial License: 10/01/1990

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,430/4,080 Initial License: 12/08/1992

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,765/3,990 Initial License: 12/08/1993

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 77 Low/High rate: 4,400/13,500 Initial License: 07/23/2012

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Gender - Capacity:

CBRF AA M - 10 Low/High rate: 2,250/2,250 Initial License: 04/18/1996

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 7,292/8,333 Initial License: 05/18/2010

Type: Class:

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS DEVELOPMENTALLY DISABLED

Gender - Capacity:

CBRF CNA M/F - 12 Low/High rate: 13,297/13,297 Initial License: 08/18/2006

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 3,060/4,402 Initial License: 04/11/2003

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 49

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 4,696/7,026 Initial License: 07/28/1998

Type: Class:

CLARE BRIDGE OF LACROSSE (510386) 3161 EAST AVE SOUTH LACROSSE WI 54601 (608) 788-2832 JESSICA LAPIC County: LACROSSE EAGLE CREST MEMORY CARE (0012129) 351 MASON STREET ONALASKA WI 54650 (608) 779-1700 ROCHELLE POULIN County: LACROSSE Association Approval: Leading Age GERARD HALL (510021) 940 DIVISION STREET LACROSSE WI 54601 (608) 392-3985 GRETCHEN SCHARRINGHAUSEN County: LACROSSE GROUP HOME 1 (510373) 518 S 10TH ST LACROSSE WI 54601 (608) 782-8038 GRETCHEN SCHARRINGHAUSEN County: LACROSSE HELEN HOUSE A INC (0011677) 1614 HENRY JOHNS BLVD BANGOR WI 54614 (608) 486-4210 ROBERT WIEDL County: LACROSSE LKI GREEN BAY STREET (0013452) 938 GREEN BAY STREET ONALASKA WI 54650 (608) 781-2313 LINDA SEIDEL County: LACROSSE MAPLEWOOD CBRF (0012298) 914 E GARLAND WEST SALEM WI 54669 (608) 786-1400 WANDA PLACHECKI County: LACROSSE Association Approval: Leading Age MEADOWS AT SPRINGBROOK (THE) (0013768) 861 CRITTER CT ONALASKA WI 54650 (608) 783-2292 DEB HARRIS County: LACROSSE SAGEN CENTRE (0009751) 2221 SIMS PLACE LACROSSE WI 54601 (608) 784-2182 ALEXANDRA PAPPAS County: LACROSSE Association Approval: Leading Age SCARSETH HOUSE (0010980) 535 S 17TH ST LACROSSE WI 54601 (608) 392-4542 JOSH COURT County: LACROSSE SIENA HALL (510055) 608 SOUTH 11TH ST LACROSSE WI 54601 (608) 784-6010 GRETCHEN SCHARRINGHAUSEN County: LACROSSE STERLING HOUSE OF LACROSSE (510387) 3141 EAST AVE SOUTH LACROSSE WI 54601 (608) 788-7730 JENNIFER HAGEN County: LACROSSE

BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 JESSICA LAPIC 3161 E AVENUE SOUTH LACROSSE WI 54601 BETHANY LUTHERAN HOMES INC (608) 779-1707 TODD WILSON 351 MASON STREET ONALASKA WI 54650 MAYO CLINIC HEALTH SYSTEM-FRANCISCAN M (608) 392-9582 BECKY WILSON-PODLENA 608 S 11TH STREET LACROSSE WI 54601 MAYO CLINIC HEALTH SYSTEM-FRANCISCAN M (608) 785-0940 GRETCHEN SCHARRINGHAUSEN 608 SOUTH 11TH LACROSSE WI 54601 HELEN HOUSE A INC (608) 486-4210 ROBERT WIEDL 1614 HENRY JOHNS BLVD BANGOR WI 54614 LORI KNAPP INC (608) 326-5536 KELLY GOCHENAUR 106 S BEAUMONT RD PRAIRIE DU CHIEN WI 53821 LAKEVIEW HEALTH CENTER (608) 786-1400 WANDA PLACHECKI 902 E GARLAND ST WEST SALEM WI 54669 SPRINGBROOK COMMUNITY ASSISTED LIVING I (608) 783-2292 ROBERT SIMONSON P O BOX 1255 SUN PRAIRIE WI 53590 BETHANY LUTHERAN HOMES INC (608) 775-9900 DONNA MILLER 2221 SIMS PLACE LACROSSE WI 54601 MAYO CLINIC HEALTH SYSTEM-FRANCISCAN M (608) 392-9582 JOSH COURT 212 S 11TH ST LACROSSE WI 54601 MAYO CLINIC HEALTH SYSTEM-FRANCISCAN M (608) 785-0940 GRETCHEN SCHARRINGHAUSEN 608 S 11TH STREET LACROSSE WI 54601 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 JENNIFER HAGEN 3141 EAST AVENUE SOUTH LACROSSE WI 54601

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,295/4,600 Initial License: 01/04/2008

Type: Class:

CBRF AA Gender - Capacity: F - 8 Low/High rate: 6,371/8,789 Initial License: 04/01/1983

Type: Class:

PREGNANT WOMEN/COUNSELLING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,131/2,227 Initial License: 03/13/1998

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,686/3,065 Initial License: 09/29/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,467/6,083 Initial License: 10/05/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 4,170/4,950 Initial License: 03/01/2008

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/4,900 Initial License: 10/17/2011

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,282/2,282 Initial License: 06/27/2002

Type: Class:

CBRF AA Gender - Capacity: M - 8 Low/High rate: 4,092/6,234 Initial License: 08/01/2006

Type: Class:

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 20 Low/High rate: 3,696/4,706 Initial License: 01/01/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 3,200/5,500 Initial License: 07/28/1998

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 50

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/4,300 Initial License: 11/11/1997

Type: Class:

STERLING HOUSE OF ONALASKA (510379) 949 10TH AVENUE NORTH ONALASKA WI 54650 (608) 783-4955 SUSAN STEIVANG County: LACROSSE UNITY HOUSE FOR MEN (510119) 1922-1924 MILLER ST LACROSSE WI 54601 (608) 775-4753 SARAH MELDE County: LACROSSE UNITY HOUSE FOR WOMEN (510151) 1312-5TH AVE S LACROSSE WI 54601 (608) 775-4718 SARAH MELDE County: LACROSSE UNITY HOUSE I (510063) 1918 1920 MILLER ST LACROSSE WI 54601 (608) 791-4752 SARAH MELDE County: LACROSSE WOMENS LAAR HOUSE (0010477) 1005 JACKSON ST LACROSSE WI 54601 (608) 392-6147 PAM REYNOLDS County: LACROSSE M & M GROUP HOME (110270) 30068 COUNTY B PLATTEVILLE WI 53818 (608) 348-9954 MADELINE FLOGEL County: LAFAYETTE SHULLSBURG HOME CBRF (110186) 204 E WATER ST SHULLSBURG WI 53586 (608) 965-4454 THERESA SPILLANE County: LAFAYETTE SIENNA CREST DARLINGTON (0009501) 1619 FAYETTE RD DARLINGTON WI 53530 (608) 776-3477 SUSAN WHITE County: LAFAYETTE CARE PARTNERS ASSISTED LVG ANTIGO (0009020) 915 FIRST AVENUE ANTIGO WI 54409 (715) 627-4698 CHERYL WALTON County: LANGLADE

BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 SUSAN STEIVANG 949 10TH AVENUE NORTH ONALASKA WI 54650 GUNDERSEN LUTHERAN MEDICAL CENTER IN (608) 775-2603 SARAH MELDE 1900 SOUTH AVE LACROSSE WI 54601 GUNDERSEN LUTHERAN MEDICAL CENTER IN (608) 785-0530 SARAH MELDE 1900 SOUTH AVE LACROSSE WI 54601 GUNDERSEN LUTHERAN MEDICAL CENTER IN (608) 785-0530 SARAH MELDE 1900 SOUTH AVE LACROSSE WI 54601 MAYO CLINIC HEALTH SYSTEM-FRANCISCAN M (608) 785-0940 BECKY WILSON-PODLENA 608 S 11TH ST LACROSSE WI 54601 MADELINE FLOGEL (608) 348-9954 MADELINE FLOGEL 30068 COUNTY B PLATTEVILLE WI 53818 SHULLSBURG MEMORIAL HOSPITAL ASSOCIA (608) 965-4454 MELANIE ANDREWS 204 E WATER ST SHULLSBURG WI 53586 SIENNA CREST ASSISTED LIVING INC (608) 835-0040 SUSAN WHITE PO BOX 45 OREGON WI 53575 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54902

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT

CBRF AA Gender - Capacity: M - 8 Low/High rate: 13,710/20,640 Initial License: 02/16/1981

Type: Class:

CBRF AA Gender - Capacity: F - 8 Low/High rate: 13,230/19,830 Initial License: 08/01/1989

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 8 Low/High rate: 13,230/19,830 Initial License: 12/30/1982

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 9 Low/High rate: 4,801/16,523 Initial License: 03/18/2004

Type: Class:

ALCOHOL/DRUG DEPENDENT

CBRF CS Gender - Capacity: M - 8 Low/High rate: 1,500/3,300 Initial License: 11/01/1989

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 2,139/2,232 Initial License: 02/28/1982

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 2,975/4,475 Initial License: 10/29/2001

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 14 Low/High rate: 1,945/3,645 Initial License: 05/21/2000

Type: Class:

EIGHT REASONS GROUP HOME (610031) 1105 8TH AVENUE ANTIGO WI 54409 (715) 627-4933 FRANK SUS JR County: LANGLADE EVERGREEN TERRACE LLC (611048) 715 ACKLEY STREET ANTIGO WI 54409 (715) 623-0423 GARY VOYTOVICH County: LANGLADE ROSALIA GARDENS (0008499) 519 FLIGHT ROAD ANTIGO WI 54409 (715) 627-2613 JENNIFER RENFRO County: LANGLADE

(715) 627-2722 FRANK SUS JR N6690 MCCLOUD ROAD GLEASON WI 54435-0000 EVERGREEN TERRACE LLC (715) 623-0423 GARY VOYTOVICH 715 ACKLEY STREET ANTIGO WI 54409 LANGLADE MEMORIAL HOSPITAL (715) 623-2331 JENNIFER RENFRO 519 FLIGHT ROAD ANTIGO WI 54409

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 1,975/2,475 Initial License: 04/01/1987

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,220/4,655 Initial License: 10/06/1998

Type: Class:

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 3,020/3,335 Initial License: 02/03/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 51

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 1,468/4,000 Initial License: 12/01/2012

Type: Class:

ARTISAN MERRILL I (THE) (0014430) 1207 WEST TAYLOR ST MERRILL WI 54452 (715) 536-3666 HEATHER LAVOIE County: LINCOLN ARTISAN MERRILL II (THE) (0014431) 1209 WEST TAYLOR ST MERRILL WI 54452 (715) 536-3666 HEATHER LAVOIE County: LINCOLN BELL TOWER RESIDENCE (610143) 1500 O'DAY STREET MERRILL WI 54452 (715) 536-5575 PEGGY JACKELEN County: LINCOLN

MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 BELL TOWER RESIDENCE INC (715) 536-5575 PEGGY JACKELEN 1500 O'DAY STREET MERRILL WI 54452

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 1,468/4,000 Initial License: 12/01/2012

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 90 Low/High rate: 3,150/3,515 Initial License: 09/27/1990

Type: Class:

BETHESDA LUTHERAN COMMUNITIES-RAILWAY (0011614) BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 18 SOUTH RAILWAY STREET GRETCHEN BLOCK TOMAHAWK WI 54487 700 HOFFMAN DRIVE (715) 453-7615 LORI LEMKE WATERTOWN WI 53094 County: LINCOLN DEER VIEW (0008646) W 5029 DOERING ROAD MERRILL WI 54452 (715) 539-8321 JULIE WEBER County: LINCOLN HIAWATHA HOME (610117) 825 CHARLES AVENUE TOMAHAWK WI 54487 (715) 453-7555 JULIE WEBER County: LINCOLN OUR WAY GROUP HOME (610044) 427 NORTH 5TH STREET TOMAHAWK WI 54487 (715) 453-8281 JULIE WEBER County: LINCOLN PAT WEBER MEMORIAL HOME (0010645) 1108 EAST 9TH STREET MERRILL WI 54452 (715) 539-9880 JULIE WEBER County: LINCOLN WOODLAND COURT ELDER SERVICES LLC (0008890) 1102 SOUTH CENTER AVENUE MERRILL WI 54452 (715) 539-9700 MELISSA DENGEL County: LINCOLN OUR WAY INC (715) 453-7555 JULIE WEBER PO BOX 76 TOMAHAWK WI 54487 OUR WAY INC (715) 453-7555 JULIE WEBER PO BOX 76 TOMAHAWK WI 54487 OUR WAY INC (715) 453-7555 SUSAN HAWKINS PO BOX 76 TOMAHAWK WI 54487 OUR WAY INC (715) 453-7555 JULIE WEBER PO BOX 76 TOMAHAWK WI 54487 DARREL/MELISSA DENGEL (715) 539-9700 MELISSA DENGEL 1102 SOUTH CENTER AVENUE MERRILL WI 54452

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,153/6,153 Initial License: 10/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 2,252/5,214 Initial License: 07/22/1999

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 1,641/6,639 Initial License: 06/28/1989

Type: Class:

CBRF CA Gender - Capacity: M/F - 6 Low/High rate: 672/4,427 Initial License: 09/30/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,852/5,446 Initial License: 08/09/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,600/3,900 Initial License: 03/30/2000

Type: Class:

WOODLAND COURT ELDER SERVICES LLC II (0009754) 1102 SOUTH CENTER AVENUE #2 MERRILL WI 54452 (715) 536-3399 MELISSA DENGEL County: LINCOLN

DARREL&MELISSA DENGEL (715) 536-3399 MELISSA DENGEL 1102 SOUTH CENTER AVENUE MERRILL WI 54452

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,600/3,800 Initial License: 11/12/2002

Type: Class:

ARTISAN MANITOWOC (THE) (0014429) 1480 NORTH 7TH ST MANITOWOC WI 54220 (920) 686-0160 LUANN LUCKOW County: MANITOWOC

MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,282/3,610 Initial License: 12/01/2012

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 52

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 1,995/3,645 Initial License: 07/31/2000

Type: Class:

CARE PARTNERS KIEL (0009053) 65 RIVERVIEW RD KIEL WI 53042 (920) 894-7978 VICKY PIONKE County: MANITOWOC CARE PARTNERS MANITOWOC (0009054) 1858 MIRRO DR MANITOWOC WI 54220 (920) 684-2077 ASHLEY GRAYKOWSKI County: MANITOWOC FIELD OF DREAMS ASSISTED LIVING (0014283) 505 BELITZ DR KIEL WI 53042 (920) 286-6189 MARY B SPAETH County: MANITOWOC FIELDCREST MANOR (410217) 1510 S 30TH ST MANITOWOC WI 54220 (920) 682-8980 MICHAEL DUNN County: MANITOWOC HANNAH HOME (0009173) 4025 DELTA ST MANITOWOC WI 54220 (920) 686-1131 ANNETTE SCHISEL County: MANITOWOC HANNAH HOME II (0013211) 3407 WILDWOOD DR MANITOWOC WI 54220 (920) 686-1811 ANNETTE M SCHISEL County: MANITOWOC HARBOR HOUSE MANITOWOC (0013437) 3720 MENASHA AVE MANITOWOC WI 54220 (920) 682-5744 LEAH ZEHEL County: MANITOWOC HARMONY OF MANITOWOC WEST (0008712) 2115 CAPPAERT RD MANITOWOC WI 54220 (920) 686-1797 KIRSTEN QUAM County: MANITOWOC Association Approval: WiCAL HARMONY OF TWO RIVERS (0008713) 4606 MISHICOT RD TWO RIVERS WI 54241 (920) 794-1950 KIRSTEN QUAM County: MANITOWOC Association Approval: WiCAL HIL LIGHTHOUSE (0009804) 1301 N 24TH ST MANITOWOC WI 54220 (920) 684-4031 STEPHANIE BROWN County: MANITOWOC HIL NEWPORT HOME (0009730) 3609 HECKER RD MANITOWOC WI 54220 (920) 684-8755 STEPHANIE BROWN County: MANITOWOC HIL WHITETAIL COURT (0014007) 4705 WHITETAIL CT MANITOWOC WI 54220 (920) 682-6854 STEPHANIE BROWN County: MANITOWOC

CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 FIELD OF DREAMS ASSISTED LIVING LLC (608) 432-1470 SCOTT A LEWIS 505 BELITZ DR KIEL WI 53042 FIELDCREST MANOR INC (920) 682-8980 MICHAEL/CHRIS DUNN 1510 S 30TH ST MANITOWOC WI 54220 SCHISEL (920) 684-4717 ANNETTE SCHISEL 3110 POPLAR RD MANITOWOC WI 54220 ANNETTE M SCHISEL (920) 684-4717 ANNETTE M SCHISEL 3110 POPLAR RD MANITOWOC WI 54220 AZURA MANITOWOC LLC (920) 682-5744 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 HOMES FOR INDEPENDENT LIVING OF WISCON (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 1,995/3,645 Initial License: 07/05/2000

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 2,950/4,450 Initial License: 10/26/2012 CBRF CS Gender - Capacity: M/F - 20 Low/High rate: 1,875/2,200 Initial License: 07/01/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,967/3,417 Initial License: 11/09/2000

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,700/3,300 Initial License: 03/02/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 9 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 43 Low/High rate: 2,295/4,100 Initial License: 07/01/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 2,600/3,665 Initial License: 07/01/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CS Gender - Capacity: M - 6 Low/High rate: 6,341/6,341 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,049/5,049 Initial License: 01/01/2002

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,480/3,600 Initial License: 02/29/2012

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 53

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CA Gender - Capacity: M/F - 7 Low/High rate: 4,475/4,475 Initial License: 01/01/2002

Type: Class:

HIL WISCONSIN HOME (0009731) 1348-1350 S 39TH ST MANITOWOC WI 54220 (920) 682-6594 STEPHANIE BROWN County: MANITOWOC KINDREDHEARTS MANITOWOC (0009723) 5005 VISTA RD MANITOWOC WI 54220 (920) 686-0870 DEB ELLIS County: MANITOWOC LAUREL GROVE ASSISTED LIVING CENTER (0009274) 1308 S 22ND ST MANITOWOC WI 54220 (920) 682-8254 TODD MEERDINK County: MANITOWOC Association Approval: Leading Age MARCO SERVICES INC (410023) 1114 S 11TH ST MANITOWOC WI 54220 (920) 684-0605 MARK STEPHENS County: MANITOWOC OAKWOOD HOME (0010180) 1220 S 8TH ST MANITOWOC WI 54220 (920) 686-9266 RENEE DERENNE County: MANITOWOC PARKWAY GROUP HOME (410024) 1110 VICTORY ST TWO RIVERS WI 54241 (920) 793-4480 THOMAS KEIL County: MANITOWOC PINES GROUP HOME (410025) 716 S 24TH ST MANITOWOC WI 54220 (920) 682-0017 EUNICE LANTOW County: MANITOWOC POINT CREEK HOME (410554) 1722 NEW YORK AVE MANITOWOC WI 54220 (920) 683-9388 JOLEEN MANRING County: MANITOWOC

HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 LYNN MATZKE 1249 RUSSETT CT GREEN BAY WI 54313 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 DEB ELLIS 5005 VISTA RD MANITOWOC WI 54220 SHADY LANE INC (920) 682-8254 TODD MEERDINK 1235 S 24TH ST MANITOWOC WI 54220 MARCO SERVICES INC (920) 684-0605 MARK STEPHENS 1114 S 11TH ST MANITOWOC WI 54220 INDEPENDENT RESIDENTIAL OPTIONS INC (920) 684-3992 RENEE DERENNE 1220 S 8TH ST MANITOWOC WI 54220 HOLIDAY HOUSE OF MANITOWOC CO INC (920) 682-4663 EUNICE LANTOW PO BOX 579 MANITOWOC WI 54221-0579 HOLIDAY HOUSE OF MANITOWOC CO INC (920) 682-4663 EUNICE LANTOW PO BOX 579 MANITOWOC WI 54221-0579 MANRING (920) 901-1063 JOLEEN MANRING 1722 NEW YORK AVE MANITOWOC WI 54220-3144

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,750/2,855 Initial License: 10/02/2002

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 63 Low/High rate: 1,300/5,740 Initial License: 06/06/2001

Type: Class:

CBRF AA Gender - Capacity: M/F - 12 Low/High rate: 1,932/1,932 Initial License: 04/01/1980

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,477/4,477 Initial License: 09/16/2003

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 8 Low/High rate: 2,096/2,096 Initial License: 05/01/1980

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,361/2,361 Initial License: 03/01/1980

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 2,400/2,900 Initial License: 01/13/1996

Type: Class:

RAINBOW HOUSE (0011339) 3100 SOUTHBROOK CT MANITOWOC WI 54220 (920) 684-4851 MARCIA M CHRISTIANSEN County: MANITOWOC Association Approval: WiCAL REIFS HARMONY HOUSE II (0010073) 2303 MARSHALL ST MANITOWOC WI 54220 (920) 683-9105 ANN KING County: MANITOWOC REIFS HARMONY HOUSE INC (0009600) 1605 CLARK ST MANITOWOC WI 54220 (920) 683-0204 KAREN REIF County: MANITOWOC

MARCIA CHRISTIANSEN (920) 683-3697 MARCIA CHRISTIANSEN 3100 SOUTHBROOK CT MANITOWOC WI 54220 REIFS HARMONY HOUSE INC (920) 683-0204 KAREN REIF 1605 CLARK ST MANITOWOC WI 54220 REIFS HARMONY HOUSE INC (920) 683-0204 KAREN REIF 1605 CLARK ST MANITOWOC WI 54220

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,198/6,422 Initial License: 12/21/2006

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,900/2,900 Initial License: 05/15/2003

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,607/2,694 Initial License: 04/01/2002

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 54

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: F - 6 Low/High rate: 2,184/2,184 Initial License: 01/09/1995

Type: Class:

SAVAGES PARK PLACE LLC (410400) 622 N 7TH ST MANITOWOC WI 54220 (920) 682-5237 KARIN SAVAGE County: MANITOWOC TLC HOMES (0010467) 2214 11TH ST TWO RIVERS WI 54241 (920) 694-1166 TIM FREY County: MANITOWOC TLC HOMES FLEETWOOD (0014314) 4438 FLEETWOOD DR MANITOWOC WI 54220 (920) 694-1192 TIM FREY County: MANITOWOC VILLA THE (0012792) 1600 S 18TH ST MANITOWOC WI 54220 (920) 684-7171 BARBARA FRICKE County: MANITOWOC Association Approval: Leading Age WHITETAIL ESTATES II (0008690) 910 RIVER BLUFF DR MANITOWOC WI 54220 (920) 686-1981 NANCY FULLER County: MANITOWOC WISTERIA HAUS (410398) 2741 45TH ST TWO RIVERS WI 54241 (920) 793-1520 MARY BUDNIK County: MANITOWOC APPLEGATE REFLECTIONS (0012101) 3001 WESTHILL DRIVE WAUSAU WI 54401 (715) 849-1514 KRYSTENA SAUTER County: MARATHON ARTISAN WAUSAU (THE) (0014435) 111 NORTH BELLIS WAUSAU WI 54403 (715) 849-2740 JODI HERNANDEZ County: MARATHON BACK COUNTRY MANOR (0011758) S645 HANSON ROAD SPENCER WI 54479 (715) 659-4729 SHANE BOE County: MARATHON BELLEWOOD AVENUE COMMUNITY RESIDENCE (610255) 2211 BELLEWOOD AVENUE SCHOFIELD WI 54476 (715) 355-9099 CHERYL ZEINERT County: MARATHON BISSELL STREET COMMUNITY RESIDENCE (610159) 1408 BISSELL STREET WAUSAU WI 54401 (715) 675-4252 NANCY SCHULZ County: MARATHON CADY HOME WEST 1 (0008829) 1805 NORTH 6TH AVENUE WAUSAU WI 54401 (715) 675-5487 TRACY ANDERSON County: MARATHON

SAVAGE (920) 652-0438 KARIN SAVAGE 123 CLEVELAND AVE MANITOWOC WI 54220 TLC HOMES INC (920) 457-0826 TIM FREY 633 ST CLAIR AVE SHEBOYGAN WI 53081 TLC HOMES INC (920) 457-0826 TIM FREY 633 ST CLAIR AVE SHEBOYGAN WI 53081 ST MARYS HOME FOR THE AGED (920) 684-7171 RANDALL KRENTZ 1600 S 18TH ST MANITOWOC WI 54220 WHITETAIL ESTATES INC (920) 686-1981 NANCY FULLER 910 RIVER BLUFF DR MANITOWOC WI 54220 WISTERIA INC (920) 793-1520 MARY BUDNIK 2741 45TH ST TWO RIVERS WI 54241 EHF WAUSAU AL OP LLC (414) 908-8000 KRYSTENA SAUTER 3001 WESTHILL DRIVE WAUSAU WI 54401 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 SHANE/TED BOE (715) 659-4389 SHANE BOE S635 HANSON ROAD SPENCER WI 54479 NORTH CENTRAL HEALTH CARE (715) 848-4477 JO POESKE 1100 LAKEVIEW DRIVE WAUSAU WI 54403 NORTH CENTRAL HEALTH CARE (715) 848-4477 JO POESKE 1100 LAKEVIEW DRIVE WAUSAU WI 54403 CADY MEMORIAL HOME INC (715) 449-3177 SALLY RIPLEY PO BOX 220 BIRNAMWOOD WI 54414

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,978/3,978 Initial License: 12/27/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,800/5,250 Initial License: 02/05/2013

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 35 Low/High rate: 2,980/3,600 Initial License: 05/15/2009

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 1,922/3,698 Initial License: 07/28/1999

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,900/3,400 Initial License: 02/10/1996

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,200/5,500 Initial License: 12/01/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 2,420/2,800 Initial License: 12/01/2012

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,650/2,650 Initial License: 02/07/2007

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 4,836/6,813 Initial License: 10/17/1994

Type: Class:

Gender - Capacity:

CBRF CNA M-6 Low/High rate: 3,762/5,475 Initial License: 11/12/1991

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,500/3,500 Initial License: 09/22/1999

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 55

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,500 Initial License: 09/22/1999

Type: Class:

CADY HOME WEST 2 (0008811) 1815 NORTH 6TH AVENUE WAUSAU WI 54401 (715) 675-5726 TRACY ANDERSON County: MARATHON CARE PARTNERS ASSISTED LIVING WESTON (0011313) 5855 DELIKOWSKI STREET WESTON WI 54476 (715) 355-0322 HEATHER ROMATOWSKI County: MARATHON CARE PARTNERS ASSISTED LIVING WESTON II (0013949) 5905 DELIKOWSKI ST WESTON WI 54476 (715) 298-1688 HEATHER ROMATOSKI County: MARATHON CEDAR CREEK MANOR I (611026) 2480 TERREBONNE DRIVE MOSINEE WI 54455 (715) 355-8246 LINDA FOSICK County: MARATHON CEDAR CREEK MANOR II (0009074) 2482 TERREBONNE DRIVE MOSINEE WI 54455 (715) 241-8807 LINDA FOSICK County: MARATHON CEDAR RIDGE ELDER SERVICES I (0011516) 4930 ALDERSON STREET SCHOFIELD WI 54476 (715) 359-1700 PAULA ROBAZEK County: MARATHON CEDAR RIDGE ELDER SERVICES II (0011517) 4932 ALDERSON STREET SCHOFIELD WI 54476 (715) 359-4838 PAULA ROBAZEK County: MARATHON CEDAR RIDGE ELDER SERVICES III (0011519) 2309 ROSS AVENUE SCHOFIELD WI 54476 (715) 355-6170 PAULA ROBAZEK County: MARATHON CEDAR RIDGE ELDER SERVICES IV (0011518) 385 ORBITING DRIVE MOSINEE WI 54455 (715) 693-7024 PAULA ROBAZEK County: MARATHON CHADWICK STREET COMMUNITY RESIDENCE (610254) 5006 CHADWICK STREET SCHOFIELD WI 54476 (715) 355-7759 NANCY SCHULZ County: MARATHON EVERGREEN PARK ASSISTED LIVING (0014039) 1957 KOWALSKI RD KRONENWETTER WI 54455 (715) 903-0177 TAMMY RUENGER County: MARATHON

CADY MEMORIAL HOME INC (715) 449-3177 SALLY RIPLEY PO BOX 220 BIRNAMWOOD WI 54414 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 (715) 355-8751 CATHERINE FOSICK 2480 TERREBONNE DRIVE MOSINEE WI 54455 CATHERINE FOSICK (715) 355-8751 CATHERINE FOSICK 2480 TERREBONNE DRIVE MOSINEE WI 54455 PAULA & MARTIN ROBAZEK (715) 432-2811 PAULA ROBAZEK 2309 ROSS AVENUE SCHOFIELD WI 54476 PAULA & MARTIN ROBAZEK (715) 432-2811 PAULA ROBAZEK 2309 ROSS AVENUE SCHOFIELD WI 54476 PAULA & MARTIN ROBAZEK (715) 432-2811 PAULA ROBAZEK 2309 ROSS AVENUE SCHOFIELD WI 54476 PAULA & MARTIN ROBAZEK (715) 432-2811 PAULA ROBAZEK 2309 ROSS AVENUE SCHOFIELD WI 54476 NORTH CENTRAL HEALTH CARE (715) 848-4403 JO POESKE 1100 LAKEVIEW DRIVE WAUSAU WI 54403 EVERGREEN PARK LLC (715) 903-0177 TAMMY RUENGER 1957 KOWALSKI RD KRONENWETTER WI 54455

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,200/3,800 Initial License: 02/15/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,700/4,500 Initial License: 11/14/2011

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 2,910/3,256 Initial License: 01/29/1998

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,910/3,256 Initial License: 09/01/2000 CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 1,645/4,699 Initial License: 06/06/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 1,646/4,699 Initial License: 06/06/2006

Type: Class:

CBRF CS Gender - Capacity: M/F - 11 Low/High rate: 1,646/4,699 Initial License: 06/06/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 1,646/4,699 Initial License: 06/06/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 4,805/6,328 Initial License: 10/12/1994

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 3,600/3,600 Initial License: 04/20/2012

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 56

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

HARBOR HOUSE RIB MOUNTAIN (0013419) 3704 HUMMINGBIRD RD WAUSAU WI 54401 (715) 355-0812 EVE MONTGOMERY County: MARATHON HARMONY OF TERRACE COURT (0008864) 3402 TERRACE COURT WAUSAU WI 54401 (715) 843-5230 CORINA KRUEGER County: MARATHON Association Approval: WiCAL HEATHER STREET COMMUNITY RESIDENCE (610246) 5010 HEATHER STREET SCHOFIELD WI 54476 (715) 359-4815 CHERYL ZEINERT County: MARATHON LILI I (0014212) 1404 LILI LN SCHOFIELD WI 54476 (715) 355-0586 DAWN POPHAL County: MARATHON

AZURA WAUSAU LLC (715) 355-0812 CARRIE ZOLADZ 6405 CENTURY AVE, SUITE 104 MIDDLETON WI 53562 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 NORTH CENTRAL HEALTH CARE (715) 848-4403 JO POESKE 1100 LAKEVIEW DRIVE WAUSAU WI 54403 LILI I CBRF LLC (715) 581-0240 JAN KOCHA 3402 RIVERVIEW CT WAUSAU WI 54403

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 35 Low/High rate: 1,600/4,600 Initial License: 12/01/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 4,587/5,565 Initial License: 09/12/1994

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/5,500 Initial License: 06/08/2012

Type: Class:

LILI II (0014213) 1408 LILI LN SCHOFIELD WI 54476 (715) 298-0218 DAWN POPHAL County: MARATHON

LILI II CBRF LLC (715) 845-9313 JAN KOCHA 3402 RIVERVIEW CT WAUSAU WI 54403

Gender - Capacity:

CBRF CNA M/F - 25 Low/High rate: 3,500/5,500 Initial License: 06/08/2012

Type: Class:

LINCOLN HOUSE CBRF LLC (0014324) 812 LINCOLN AVE WAUSAU WI 54403 (715) 848-1745 DAWN POPHAL County: MARATHON MARA CBRF LLC (0014211) 663 MARATECH AVENUE MARATHON CITY WI 54448 (715) 443-2727 ANN BERRY County: MARATHON

LINCOLN HOUSE CBRF LLC (715) 581-0240 JAN KOCHA 3402 RIVERVIEW CT WAUSAU WI 54403 MARA CBRF LLC (715) 581-0240 JAN KOCHA 3402 RIVERVIEW CT WAUSAU WI 54403

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,100/3,500 Initial License: 08/16/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,500/5,500 Initial License: 06/08/2012

Type: Class:

MILLER ALTERNATIVE CARE (0010053) 3013 WEST MANN STREET MARSHFIELD WI 54449 (715) 384-0574 JESSICA KLEMENT County: MARATHON

MILLER ALTERNATIVE CARE LLC (715) 897-5079 DAVID/KATHRYN MILLER W782 LEROY STREET EDGAR WI 54426

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 3,500/4,800 Initial License: 06/23/2003

Type: Class:

MILLER ELDER CARE (0010054) 3017 WEST MANN STREET MARSHFIELD WI 54449 (715) 389-8100 DAVID MILLER County: MARATHON

MILLER ALTERNATIVE CARE LLC (715) 897-5078 DAVID/KATHRYN MILLER W782 LEROY STREET EDGAR WI 54426

Gender - Capacity:

CBRF CNA M/F - 11 Low/High rate: 3,500/4,500 Initial License: 07/30/2003

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 57

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: F - 8 Low/High rate: 4,718/4,718 Initial License: 08/10/1987

Type: Class:

NCHCF GROUP HOME 1 CBRF (610091) 1115 HILLCREST AVENUE WAUSAU WI 54401 (715) 845-3733 LINDA CASS County: MARATHON NORTH CENTRAL HEALTH CARE (0012660) 1100 LAKE VIEW DRIVE WAUSAU WI 54403 (715) 848-4394 LORI KOEPPEL County: MARATHON NORTHLAND HOUSE GROUP HOME (0012487) 102 MC CLELLAN STREET WAUSAU WI 54403 (715) 845-4898 JANET NISSEN County: MARATHON NORTHSIDE ELDER ESTATE (611036) 808 NORTH THIRD AVENUE STRATFORD WI 54484 (715) 687-4786 KRISTIN SCHAR County: MARATHON OUR HOUSE ASSISTED CARE (0013424) 210 W CAMPUS DR WAUSAU WI 54401 (715) 675-4444 BECKY ANTIPOREK County: MARATHON OUR HOUSE MEMORY CARE (0013422) 220 W CAMPUS DR WAUSAU WI 54401 (715) 675-4440 JESSICA BETTS County: MARATHON OUR HOUSE MEMORY CARE (0013422) 220 W CAMPUS DR WAUSAU WI 54401 (715) 675-4440 JESSICA BETTS County: MARATHON PINE RIDGE ASSISTED LIVING COLBY (0012343) 1110 N DIVISION STREET COLBY WI 54421 (715) 223-2200 GAIL WILKINS County: MARATHON POPLAR PLACE LLC (0013100) 1204 WESTON AVENUE ROTHSCHILD WI 54474 (715) 393-4466 NANCY FISKER County: MARATHON SPRING CREST RESIDENCE (0012835) 3404 CROSS POINT BLV SCHOFIELD WI 54476 (715) 298-3101 TERRY HOWARD County: MARATHON STEVES HOME (610201) 309 BELLIS STREET WAUSAU WI 54403 (715) 842-3902 STEVE TEWES County: MARATHON

NORTH CENTRAL HEALTH CARE (715) 848-4403 JO POESKE 1100 LAKEVIEW DRIVE WAUSAU WI 54403 NORTH CENTRAL HEALTH CARE (715) 848-4600 LORI KOEPPEL 1100 LAKE VIEW DRIVE WAUSAU WI 54403 CATHOLIC RESIDENTIAL SERVICES INC (608) 784-5329 JIM GAJEWSKI PO BOX 2394 LA CROSSE WI 54602-2394 (715) 687-3383 KRISTIN SCHAR 808 NORTH 3RD AVENUE STRATFORD WI 54484 KSMS OUR HOUSE LLC KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 PINE RIDGE ASSISTED LIVING (715) 223-2200 FRED/SANDY MILLER 491 N 25TH ST WISCONSIN RAPIDS WI 54494 NANCY FISKER (715) 571-1017 NANCY FISKER 3210 SKYLARK LANE WAUSAU WI 54401 SPRING CREST RESIDENCE (715) 298-3101 DIR OF OPERATIONS 6409 W MAIN ST ARPIN WI 54410

ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING CORRECTIONAL CLIENTS

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 14,880/14,880 Initial License: 08/07/2009

Type: Class:

CBRF AA Gender - Capacity: M - 8 Low/High rate: 6,160/6,820 Initial License: 01/01/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,800/3,000 Initial License: 01/30/1998

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,100/3,300 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,500/3,550 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,450/3,500 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 48 Low/High rate: 2,800/3,500 Initial License: 06/02/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,420/4,291 Initial License: 02/03/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,513/2,463 Initial License: 06/24/2009

Type: Class:

(715) 842-3902 STEVE TEWES 309 BELLIS STREET WAUSAU WI 54403

CBRF AA Gender - Capacity: M - 6 Low/High rate: 1,619/4,562 Initial License: 06/09/1993

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 58

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 4,200/4,200 Initial License: 02/13/2001

Type: Class:

STONE CREST RESIDENCE (0009226) 805 PARCHER STREET WAUSAU WI 54403 (715) 849-9563 TRACY CORTRIGHT County: MARATHON Association Approval: Leading Age SULLIVANS 716 (0008679) 716 WASHINGTON STREET WAUSAU WI 54403 (715) 849-8408 JOHN SULLIVAN County: MARATHON SULLIVANS 727 (0009327) 727 WASHINGTON STREET WAUSAU WI 54403 (715) 849-8364 JOHN SULLIVAN County: MARATHON SUNSHINE HOME OF WAUSAU (0013924) 719 WASHINGTON ST WAUSAU WI 54403 (715) 848-8868 KATHRYN BUDIMLIJA County: MARATHON

HOMME INC OF WISCONSIN (715) 845-1214 TRACY CORTRIGHT 2901 NORTH 7TH STREET WAUSAU WI 54403

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

SULLIVAN HOMES LLC (715) 212-4325 JOHN SULLIVAN P O BOX 5066 WAUSAU WI 54402-5066 SULLIVAN HOMES LLC (715) 212-4325 JOHN SULLIVAN P O BOX 5066 WAUSAU WI 54402-1974 KATHRYN BUDIMLIJA (425) 299-2135 KATHRYN BUDIMLIJA 3869 FISHERMAN COVE MOSINEE WI 54455

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,390/2,967 Initial License: 07/09/1999

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,388/2,967 Initial License: 06/27/2001

Type: Class:

CBRF AA Gender - Capacity: F - 8 Low/High rate: 2,027/3,390 Initial License: 02/06/2012

Type: Class:

SYLVAN CROSSINGS ON EVERGREEN (0008655) 1605 EVERGREEN ROAD WAUSAU WI 54403 (715) 675-3827 PAMALA FISCHER County: MARATHON VANDER WAAL CBRF (610082) 794 CTY HWY B MOSINEE WI 54455 (715) 693-2968 DONNA VANDER WAAL County: MARATHON WELLINGTON PLACE OF RIB MOUNTAIN (0012045) 4100 NORTH MOUNTAIN ROAD WAUSAU WI 54401 (715) 842-5000 BARBARA BOENSKI County: MARATHON WILLOW HAVEN CBRF LLC (0012930) 804 12TH STREET MOSINEE WI 54455 (715) 693-8233 MARGARET BUDIMLIJA County: MARATHON

TOUCHSTONE SENIOR SERVICES LLC (608) 277-8887 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 VANDER WAAL CBRF INC (715) 693-2968 DONNA VANDER WAAL 794 CTY HWY B MOSINEE WI 54455 WELLINGTON HOMES OF WISCONSIN LLC (703) 868-0503 BARBARA BOENSKI 4100 NORTH MOUNTAIN ROAD WAUSAU WI 54401 MARGARET/DANIEL BUDIMLIJA (715) 693-2746 MARGARET/DANIEL BUDIMLIJA 3873 FISHERMANS COVE MOSINEE WI 54455

CBRF CNA Gender - Capacity: M/F - 21 Low/High rate: 2,950/4,710 Initial License: 07/01/1999

Type: Class:

Gender - Capacity:

CBRF AS M/F - 11 Low/High rate: 2,005/2,248 Initial License: 09/26/1985

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 28 Low/High rate: 3,682/5,508 Initial License: 09/07/2007

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,677/5,290 Initial License: 04/15/2010

Type: Class:

ANTHONY HOUSE (0010562) 900 WELLS STREET MARINETTE WI 54143 (715) 735-5818 PAMELA LOSINSKI County: MARINETTE EDGEWOOD MANOR (410026) 1101 NORTHLAND TERRACE LANE MARINETTE WI 54143 (715) 735-7447 COLLEEN BARKER County: MARINETTE

MARINETTE CTY SHELTER CARE GROUP HOM (715) 732-7477 PAMELA LOSINSKI 900 WELLS STREET MARINETTE WI 54143 NORTHLAND LUTHERAN RETIREMENT COMM (715) 732-0155 REV KENNETH MICHAELIS 831 PINE BEACH ROAD MARINETTE WI 54143

CBRF ANA Gender - Capacity: M/F - 12 Low/High rate: 2,044/2,263 Initial License: 05/12/2004

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,724/1,724 Initial License: 05/01/1987

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 59

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 55 Low/High rate: 2,101/3,454 Initial License: 09/28/1999

Type: Class:

LUTHER MANOR (0008721) 831 PINE BEACH ROAD MARINETTE WI 54143 (715) 732-0155 DARRELL LANCOUR County: MARINETTE Association Approval: Leading Age NEWCARE RESIDENCE (410517) 903 MAIN STREET CRIVITZ WI 54114 (715) 854-7474 STEPHANIE KOUSKI County: MARINETTE REM WISCONSIN II INC SHORE DRIVE (0012909) N2511 SHORE DR MARINETTE WI 54143 (715) 732-0615 MARY STUEBER County: MARINETTE SUN VALLEY HOMES II MARINETTE NORTH (0013965) 875 UNIVERSITY DR MARINETTE WI 54143 (715) 732-1772 PENNI FRANK County: MARINETTE SUN VALLEY HOMES II MARINETTE SOUTH (0013966) 3206 WOODLAND RD MARINETTE WI 54143 (715) 732-0589 PENNI FRANK County: MARINETTE GOLDEN YEARS INC BLDG 2 (0012700) 497 SOUTH LAKE STREET MONTELLO WI 53949 (608) 297-7999 DANYEL BOWMAN County: MARQUETTE

NORTHLAND LUTHERAN RETIREMENT COMM (715) 732-0155 DARRELL LANCOUR 831 PINE BEACH ROAD MARINETTE WI 54143 NEWCARE INC (715) 854-2717 JANELLE RYMER PO BOX 158 CRIVITZ WI 54114-0158 REM WISCONSIN II INC (608) 276-1191 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 SUN VALLEY HOMES II LLC (920) 370-2371 PENNI FRANK 875 UNIVERSITY DR MARINETTE WI 54143 SUN VALLEY HOMES II LLC (920) 370-2371 PENNI L FRANK 875 UNIVERSITY DR MARINETTE WI 54143 THOMAS JAMES BOWMAN (608) 697-0991 THOMAS BOWMAN PO BOX 705 PACKWAUKEE WI 53953

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,003/3,257 Initial License: 04/24/1998

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,971/5,971 Initial License: 09/01/2009

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,300/3,600 Initial License: 01/11/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,300/3,600 Initial License: 01/11/2012

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,550/3,200 Initial License: 03/19/2009

Type: Class:

GOLDEN YEARS INC BLDG 3 (0012736) 497 SOUTH LAKE STREET MONTELLO WI 53949 (608) 297-9883 DANYEL BOWMAN County: MARQUETTE

THOMAS JAMES BOWMAN (608) 697-0991 THOMAS BOWMAN PO BOX 705 PACKWAUKEE WI 53953

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,550/3,200 Initial License: 03/19/2009

Type: Class:

HARRIS VILLA INC (0011562) N6581 VILLA PARK WAY WESTFIELD WI 53964 (608) 296-3190 NANETTE HINZE County: MARQUETTE

HARRIS VILLA INC (608) 296-3190 NANETTE HINZE N6581 VILLA PARK WAY WESTFIELD WI 53964

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 2,600/3,000 Initial License: 09/08/2006

Type: Class:

JOANIES HOME FOR HAPPY SENIORS LLC (410115) N3849 ST HWY 22 MONTELLO WI 53949 (608) 297-7337 TEALE MUGFOR County: MARQUETTE

JOANIES HOME FOR THE HAPPY SENIOR LLC (608) 297-2705 JOAN HUNTER N3847 ST HWY 22 MONTELLO WI 53949

Gender - Capacity:

CBRF ANA M/F - 15 Low/High rate: 1,900/2,049 Initial License: 05/01/1988

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 60

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,131/23,573 Initial License: 11/01/2010

Type: Class:

MILL POND ONE (0013473) 507 MARKET ST WESTFIELD WI 53964 (262) 534-7297 GAIL SCHMITT County: MARQUETTE MILL POND TWO (0013474) 515 MARKET ST WESTFIELD WI 53964 (262) 534-7297 GAIL SCHMITT County: MARQUETTE OUR HOUSE II (0009454) N9211 CTY RD N NESHKORO WI 54960 (920) 293-4663 SCOTT LANGER County: MARQUETTE

LAKEVIEW CARE PARTNERS INC (512) 973-9700 CHRISTOPHER SLOVER 2011 RUTLAND DR AUSTIN TX 78758 LAKEVIEW CARE PARTNERS INC (512) 973-9700 CHRISTOPHER SLOVER 2011 RUTLAND DR AUSTIN TX 78758 OUR HOUSE I II III LLC (920) 293-4663 SCOTT LANGER N9211 CTY RD N NESHKORO WI 54960

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,131/23,573 Initial License: 11/01/2010

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,310/3,120 Initial License: 10/01/2001

Type: Class:

RESIDENCES ON FOREST LANE (THE) (0012609) 253 FOREST LANE MONTELLO WI 53949 (608) 297-8240 JODI GALLUP County: MARQUETTE 117TH STREET GROUP HOME (0011672) 5823 N 117TH ST MILWAUKEE WI 53226 (414) 479-9411 JILL VAN CALSTER County: MILWAUKEE 2ND CENTURY (0013598) 2187 S 85TH ST WEST ALLIS WI 53227 (414) 321-2648 ANTONIO DESHAZOR County: MILWAUKEE A PLACE FOR MIRACLES LIVING CENTER (0009870) 5100 N 42ND ST MILWAUKEE WI 53209 (414) 438-9433 TONI HOWARD County: MILWAUKEE A PLACE FOR MIRACLES LIVING CENTER II (0011085) 7022 N 43RD ST MILWAUKEE WI 53209 (414) 438-9433 TONI HOWARD County: MILWAUKEE A PLACE FOR MIRACLES LIVING CENTER III (0011885) 3927 W ROOSEVELT DR MILWAUKEE WI 53216 (414) 438-9433 TONI HOWARD County: MILWAUKEE

WISCONSIN ILLINOIS SENIOR HOUSING INC (303) 980-0611 BRENT MEYERS 253 FOREST LN MONTELLO WI 53949 CURATIVE CARE NETWORK (414) 479-9411 JILL VAN CALSTER 1000 N 92ND ST MILWAUKEE WI 53226 MATT TALBOT RECOVERY SERVICES INC (414) 529-1330 KARL RAJANI P O BOX 20007 GREENFIELD WI 53220 A PLACE FOR MIRACLES LIVING CENTER INC (414) 788-3068 TONI HOWARD 5100 N 42ND ST MILWAUKEE WI 53209 A PLACE FOR MIRACLES LIVING CENTER INC (414) 788-2638 TONI HOWARD 5100 N 42ND ST MILWAUKEE WI 53209 A PLACE FOR MIRACLES LIVING CENTER III LL (414) 788-2638 DAVID HOWARD 5100 N 42ND ST MILWAUKEE WI 53209

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,300/3,200 Initial License: 12/23/2008

Type: Class:

ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 6 Low/High rate: 3,183/3,263 Initial License: 11/01/2006

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,550/3,565 Initial License: 02/11/2011

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 6 Low/High rate: 2,400/5,550 Initial License: 06/09/2003

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 7 Low/High rate: 2,415/3,500 Initial License: 03/30/2006

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 6 Low/High rate: 2,700/3,500 Initial License: 05/01/2007

Type: Class:

ABBYHAVEN (310658) 4865 S 95TH ST GREENFIELD WI 53228 (414) 427-5432 JOANNE HOECHERL County: MILWAUKEE

GOLDEN CARE INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,278/3,278 Initial License: 10/09/1997

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 61

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 42 Low/High rate: 5,055/5,055 Initial License: 05/10/2006

Type: Class:

ABUNDANT LIFE MANOR (0011483) 1904 E BELLEVIEW PL MILWAUKEE WI 53211 (414) 962-3200 MARJORIE GLEESON County: MILWAUKEE AGAPE SUPPORTIVE LIVING SERVICES II (0010453) 4035 N 68TH ST MILWAUKEE WI 53216 (414) 213-9095 KATIE HARRIS County: MILWAUKEE AGAPE SUPPORTIVE LIVING SERVICES LLC (0009653) 2977 N 52ND ST MILWAUKEE WI 53210 (414) 444-6181 KATIE HARRIS County: MILWAUKEE ALEXIAN VILLAGE OF MILWAUKEE COURTYARD (310150) 9301 N 76TH ST MILWAUKEE WI 53223 (414) 355-9300 DEBBIE CURRAN County: MILWAUKEE ALEXIAN VILLAGE SQUARE (0008627) 9301 N 76TH ST MILWAUKEE WI 53223 (414) 355-9300 CARRIE HENSEL County: MILWAUKEE ANCHORAGE HOMES II (0012095) 3843 N 51ST BLVD MILWAUKEE WI 53216 (414) 445-7449 LUREAN SLOCUM County: MILWAUKEE ANGELS HEARTH (0013961) 3468 S 119TH ST WEST ALLIS WI 53227 (414) 727-0822 CANDACE DAHLKE County: MILWAUKEE

ABUNDANT LIFE MINISTRY INC (414) 962-3200 MARJORIE GLEESON 1904 E BELLEVIEW PL MILWAUKEE WI 53211 AGAPE SUPPORTIVE LIVING SERVICES LLC (414) 213-9095 KATIE HARRIS P O BOX 100594 MILWAUKEE WI 53210 AGAPE SUPPORTIVE LIVING SERVICES LLC (414) 213-9095 KATIE HARRIS P O BOX 100594 MILWAUKEE WI 53210 ALEXIAN VILLAGE OF MILWAUKEE INC (414) 355-9300 DEBBIE CURRAN 9301 N 76TH ST MILWAUKEE WI 53223 ALEXIAN VILLAGE OF MILWAUKEE INC (414) 355-9300 CARRIE HENSEL 9301 N 76TH ST MILWAUKEE WI 53223 L & L ANCHORAGE HOMES (414) 445-7449 LUREAN SLOCUM 5340 W MELVINA ST MILWAUKEE WI 53216 BRYANT HOMES LLC (414) 541-7067 CANDACE DAHLKE 12501 W NEEDHAM DR NEW BERLIN WI 53132

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,907/3,412 Initial License: 02/16/2004

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED

Gender - Capacity:

CBRF AA M/F - 6 Low/High rate: 2,907/3,009 Initial License: 09/16/2002

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 29 Low/High rate: 4,350/8,350 Initial License: 12/01/1991

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 64 Low/High rate: 5,040/6,590 Initial License: 07/22/1999

Type: Class:

Gender - Capacity:

CBRF CS M/F - 7 Low/High rate: 2,750/3,750 Initial License: 05/01/2008

Type: Class: Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 0/3,333 Initial License: 01/01/2012

ARBOR HOME (0011960) 4570 S 117TH ST GREENFIELD WI 53228 (414) 529-4279 SHARON JOHNSON County: MILWAUKEE ARGONNE (0011364) 9835 W ARGONNE DR WAUWATOSA WI 53222 (414) 442-5077 KIM BEQUEST County: MILWAUKEE ARK HAVEN FOR THE ELDERLY (0009966) 8050 W APPLETON AVE MILWAUKEE WI 53218 (414) 461-1752 SHERRIE LYNN BAILEY HOLLAND County: MILWAUKEE

HOMES FOR INDEPENDENT LIVING OF WISCON (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 DUNGARVIN WISCONSIN LLC (414) 443-1311 KIM BEQUEST 10425 W NORTH AVE SUITE 149 WAUWATOSA WI 53226 ARK OF THE NEW COVENANT COGIC INC (414) 462-6706 ISAAC T BAILEY JR 8057 W APPLETON AVE MILWAUKEE WI 53218

CBRF CS Gender - Capacity: M/F - 5 Low/High rate: 5,997/5,997 Initial License: 08/13/2007

Type: Class:

CBRF CNA Gender - Capacity: F - 5 Low/High rate: 4,312/5,635 Initial License: 03/31/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,879/2,500 Initial License: 03/14/2002

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 62

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,000 Initial License: 10/05/2006

Type: Class:

ARK HAVEN FOR THE ELDERLY II (0011578) 8040 W APPLETON AVE MILWAUKEE WI 53218 (414) 462-9784 SHERRIE BAILEY-HOLLAND County: MILWAUKEE

ARK OF THE NEW COVENANT COGIC (414) 462-4065 ISAAC T BAILEY JR 8057 W APPLETON AVE MILWAUKEE WI 53218

ARK HAVEN FOR THE ELDERLY III (0011579) 8030 W APPLETON AVE MILWAUKEE WI 53218 (414) 462-8725 SHERRIE BAILEY HOLLAND County: MILWAUKEE

ARK OF THE NEW COVENANT COGIC (414) 462-4065 ISSAC T BAILEY JR 8057 W APPLETON AVE MILWAUKEE WI 53218

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,000 Initial License: 10/05/2006

Type: Class:

AUBERRY HOUSE INC (0010167) 10320 S HUMMINGBIRD LN OAK CREEK WI 53154 (414) 762-3763 JODEE CHAPPELL County: MILWAUKEE AUTUMN LIVING SOUTH (0010953) 4340 S 116TH ST GREENFIELD WI 53228 (414) 425-5532 BRIAN SCHOENLEBER County: MILWAUKEE BARNETT HOUSE (310003) 2466 N 50TH ST MILWAUKEE WI 53210 (414) 871-5943 KIM BEQUEST County: MILWAUKEE BAYVIEW RESIDENTIAL FACILITY (0010439) 8820 N REXLEIGH DR BAYSIDE WI 53217 (414) 351-1464 MICHAEL YELIN County: MILWAUKEE

AUBERRY HOUSE INC (414) 762-3763 SCOTT CHAPPELL 4719 KINGDOM CT RACINE WI 53402 AUTUMN LIVING INC (414) 397-4176 ALLEN SCHOENLEBER PO BOX 182 HALES CORNERS WI 53130 TRANSITIONAL LIVING SERVICES INC (414) 476-9675 PEG DUBORD 1040 S 70TH ST MILWAUKEE WI 53214 ZVIA SHAER RN & IZHAC SHAER (414) 228-4749 ZVIA & IZHAC SHAER 2145 W HEMLOCK RD GLENDALE WI 53209

CBRF CNA Gender - Capacity: F - 8 Low/High rate: 2,800/3,200 Initial License: 10/15/2003

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,975/3,550 Initial License: 06/22/2005

Type: Class:

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,282/2,282 Initial License: 03/01/1980

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,760/3,600 Initial License: 02/09/2004

Type: Class:

BELL THERAPY BELWOOD (0010783) 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 (414) 225-4460 SARA SANDEE County: MILWAUKEE BELL THERAPY BELWOOD VIII MARTIN CBRF (310134) 1141 N 46TH ST MILWAUKEE WI 53208 (414) 344-1993 SARA SANDEE County: MILWAUKEE BELL THERAPY BLUEMOUND (310038) 101 N 75TH ST MILWAUKEE WI 53213 (414) 258-2290 SARA SANDEE County: MILWAUKEE BELL THERAPY BRENTWOOD (0011269) 7229 7231 W BRENTWOOD AVE MILWAUKEE WI 53223 (414) 358-0906 SARA SANDEE County: MILWAUKEE BELL THERAPY CHAMBERS (310079) 6328 W CHAMBERS ST MILWAUKEE WI 53210 (414) 444-2606 NATHAN ZEIGER County: MILWAUKEE

PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300

CBRF CS Gender - Capacity: M/F - 46 Low/High rate: 4,458/4,458 Initial License: 09/22/2005

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,155/3,426 Initial License: 06/10/1991

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,084/3,084 Initial License: 11/01/1984

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,606/2,606 Initial License: 06/01/2006

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,109/3,968 Initial License: 01/01/1988

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 63

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,704/3,844 Initial License: 10/31/1984

Type: Class:

BELL THERAPY CONGRESS (310059) 6333 W CONGRESS ST MILWAUKEE WI 53218 (414) 461-4670 NATHAN ZEIGER County: MILWAUKEE BELL THERAPY FLORIST (0009565) 7401 W FLORIST AVE MILWAUKEE WI 53218 (414) 438-1820 NATHAN ZEIGER County: MILWAUKEE BELL THERAPY HAMPTON (310104) 4901 N 106TH ST MILWAUKEE WI 53225 (414) 527-6970 SARA SANDEE County: MILWAUKEE BELL THERAPY KEEFE (310295) 6105 W KEEFE AVE PKWY MILWAUKEE WI 53216 (414) 447-7566 SARA SANDEE County: MILWAUKEE BELL THERAPY KIEHNAU (0011199) 10133 10135 W KIEHNAU AVE MILWAUKEE WI 53224 (414) 353-5567 SARA SANDEE County: MILWAUKEE BELL THERAPY KINNICKINNIC (KK) (0009000) 2858 S 68TH ST MILWAUKEE WI 53219 (414) 327-7510 NATHAN ZEIGER County: MILWAUKEE BELL THERAPY SHERIDAN (310057) 5470 N 19TH ST MILWAUKEE WI 53209 (414) 527-6970 SARA SANDEE County: MILWAUKEE BELL THERAPY SHERMAN (310274) 3149 N SHERMAN BLVD MILWAUKEE WI 53216 (414) 444-8282 SARA SANDEE County: MILWAUKEE BELL THERAPY SILVER SPRING (310076) 7830 W SILVER SPRING DR MILWAUKEE WI 53218 (414) 464-6460 SARA SANDEE County: MILWAUKEE BELL THERAPY SILVERLAWN (0012049) 5554-5556 N 57TH ST MILWAUKEE WI 53218 (414) 463-8006 SARA SANDEE County: MILWAUKEE BELL THERAPY THURSTON (0008680) 5734 N 94TH ST MILWAUKEE WI 53225 (414) 462-7117 SARA SANDEE County: MILWAUKEE BELL THERAPY UNDERWOOD (0009082) 3146 E UNDERWOOD CUDAHY WI 53110 (414) 489-7587 NATHAN ZEIGER County: MILWAUKEE

PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 527-6940 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 SARA SANDEE 5151 W SILVER SPRING DR MILWAUKEE WI 53218 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,111/3,758 Initial License: 04/23/2002

Type: Class:

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 3,374/3,374 Initial License: 11/21/1988

Type: Class:

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 6,407/6,407 Initial License: 03/31/1996

Type: Class:

Gender - Capacity:

CBRF CA M/F - 8 Low/High rate: 5,009/5,009 Initial License: 12/12/2005

Type: Class:

Gender - Capacity:

CBRF CA M-6 Low/High rate: 4,966/4,966 Initial License: 06/26/2000

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,088/3,088 Initial License: 07/01/1984

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AS M/F - 6 Low/High rate: 4,795/4,795 Initial License: 06/08/1996

Type: Class:

Gender - Capacity:

CBRF CA M/F - 8 Low/High rate: 3,012/3,012 Initial License: 04/01/1987

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 5,349/5,349 Initial License: 10/01/2005

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 5,299/5,299 Initial License: 08/06/1999

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 4,343/4,343 Initial License: 09/15/2000

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 64

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,145/5,360 Initial License: 05/31/1985

Type: Class:

BELL THERAPY VILLARD (310067) 8207 W VILLARD AVE MILWAUKEE WI 53218 (414) 462-6414 NATHAN ZEIGER County: MILWAUKEE BETHESDA LUTHERAN COMMUNITIES-GREENFIELD (310 6515 W HOLMES GREENFIELD WI 53220 (414) 281-9207 AMANDA MILLER County: MILWAUKEE

PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 GRETCHEN BLOCK 700 HOFFMAN DR WATERTOWN WI 53094

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,406/3,406 Initial License: 03/31/1988

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

BETHESDA LUTHERAN COMMUNITIES-RAMSEY (0010125) BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 2524 W RAMSEY AVE GRETCHEN BLOCK MILWAUKEE WI 53221 700 HOFFMANN DR (414) 282-4231 AMANDA MILLER WATERTOWN WI 53094 County: MILWAUKEE BETHESDA LUTHERAN COMMUNITIES-WEST ALLIS (310 BETHESDA LUTHERAN COMMUNITIES INC (920) 261-3050 2577 S 118TH ST GRETCHEN BLOCK WEST ALLIS WI 53227 700 HOFFMAN DR (414) 541-4451 BREANNE PROTHERO WATERTOWN WI 53094 County: MILWAUKEE BLUEMOUND HOME (0011541) 12231 W BLUEMOUND RD WAUWATOSA WI 53226 (414) 302-9400 PATTI HANSBURG County: MILWAUKEE BRADLEY (310090) 8010 N 51ST ST BROWN DEER WI 53223 (414) 355-1432 RICHARD HINTZ County: MILWAUKEE BRADLEY HOUSE (310279) 3430 S 38TH ST MILWAUKEE WI 53215 (414) 647-9298 HOLLY NYGRO County: MILWAUKEE BREATH OF LIFE RESIDENCE (0012232) 4072-4074 N 64TH ST MILWAUKEE WI 53216-0000 (414) 461-9378 LATRESHA A ROBINSON RN County: MILWAUKEE CLOSE TO HOME SENIOR LIVING CENTER INC (262) 370-8393 PATTI HANSBURG 2882 S 132ND ST NEW BERLIN WI 53151 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 HEALTHSPAN INC (414) 541-4700 LORI PAPROCKI 5520 W FOREST HOME AVE GREENFIELD WI 53220 LATRESHA A ROBINSON RN (414) 736-9775 LATRESHA A ROBINSON RN 6400 W CAPITOL DR SUITE 102 MILWAUKEE WI 53216

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,860/4,860 Initial License: 08/07/2003

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,293/4,293 Initial License: 05/01/1993

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,100/4,500 Initial License: 09/26/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,564/4,564 Initial License: 01/31/1982

Type: Class:

CBRF AA Gender - Capacity: F - 6 Low/High rate: 4,245/5,475 Initial License: 02/12/1996

Type: Class:

Gender - Capacity:

CBRF CS M/F - 7 Low/High rate: 3,500/4,000 Initial License: 02/22/2008

Type: Class:

BRIDGE HALFWAY HOUSE (310186) 2404 N 50TH ST MILWAUKEE WI 53210 (414) 442-3700 CAROL LIMBACH County: MILWAUKEE BROTOLOC FRANKLIN (0013104) 9460 S 46TH ST FRANKLIN WI 53132 (414) 423-9904 SUE MILLARD County: MILWAUKEE

WISCONSIN COMMUNITY SERVICES INC (414) 271-2512 JOSEPH SPOLOWICZ 3732 W WISCONSIN AVE SUITE 200 MILWAUKEE WI 53208 BROTOLOC SOUTH INC (414) 423-9904 SUE MILLARD 209 S TAFT ST WHITEWATER WI 53190

CBRF AA Gender - Capacity: M - 36 Low/High rate: 2,112/2,640 Initial License: 02/14/1994

Type: Class:

CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,589/6,374 Initial License: 02/05/2010

Type: Class:

BROTOLOC GREENFIELD (0013102) 3826 S 36TH ST GREENFIELD WI 53221 (414) 325-0741 SUE MILLARD County: MILWAUKEE

BROTOLOC SOUTH INC (262) 473-0480 SUE MILLARD 209 S TAFT ST WHITEWATER WI 53190

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 5,870/6,008 Initial License: 02/05/2010

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 65

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 5,414/5,735 Initial License: 02/05/2010

Type: Class:

BROTOLOC WEST ALLIS (0013103) 2355 S 68TH ST WEST ALLIS WI 53219 (414) 329-8403 SUE MILLARD County: MILWAUKEE BURLEIGH HOUSE (310066) 8221 W BURLEIGH ST MILWAUKEE WI 53222 (414) 449-9891 KIM BEQUEST County: MILWAUKEE CALUMET CORNERS I (0011786) 10730 W CALUMET RD MILWAUKEE WI 53224 (414) 355-5921 LINDA J WITZLIB County: MILWAUKEE CAMELOT HOME (0011972) 4900 S 68TH ST GREENFIELD WI 53220 (414) 817-9188 KRISTOPHER KIEFER County: MILWAUKEE CAMEO COURT LLC (0011089) 5790 S 27TH ST MILWAUKEE WI 53221 (414) 282-1300 DRAGAN KRESOVIC County: MILWAUKEE

BROTOLOC SOUTH INC (262) 473-0480 SUE MILLARD 209 S TAFT ST WHITEWATER WI 53190 TRANSITIONAL LIVING SERVICES INC (414) 476-9675 PEG DUBORD 1040 S 70TH ST MILWAUKEE WI 53214 LINDA WITZLIB (414) 708-4802 LINDA J WITZLIB 7060 N 124TH ST MILWAUKEE WI 53224 CASTLE HOMES CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228 CAMEO COURT LLC (414) 282-1300 DRAGAN KRESOVIC 5790 S 27TH ST MILWAUKEE WI 53221

CBRF AA Gender - Capacity: F - 8 Low/High rate: 3,188/3,506 Initial License: 05/01/1985

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 7,340/7,584 Initial License: 02/16/2007

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,750/3,200 Initial License: 06/11/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,164/4,500 Initial License: 03/14/2006

Type: Class:

CAMILLUS COURT EAST (310158) 10100 W BLUEMOUND RD WAUWATOSA WI 53226 (414) 259-3784 DAVID TANCK County: MILWAUKEE CAMILLUS COURT WEST (310109) 530 N 103RD ST WAUWATOSA WI 53226 (414) 259-3702 MARIE D'AMICO County: MILWAUKEE CANTERBURY COURT (310175) 1840 N PROSPECT AVE MILWAUKEE WI 53202 (414) 831-6976 JOHN W GEORGE County: MILWAUKEE Association Approval: Leading Age CAPITOL TERRACE (0013418) 4019 N 87TH ST MILWAUKEE WI 53222 (414) 466-9140 MICHAEL ROGINSKIY County: MILWAUKEE

SAN CAMILLO INC (414) 258-1814 DAVID TANCK 10101 W WISCONSIN AVE WAUWATOSA WI 53226 SAN CAMILLO INC (414) 258-1814 MARIE D'AMICO 10101 W WISCONSIN AVE WAUWATOSA WI 53226 ST JOHNS COMMUNITIES INC (414) 272-2022 JOHN W GEORGE 1840 N PROSPECT AVE MILWAUKEE WI 53202 AURORA HOME CARE LLC (414) 745-3053 MICHAEL ROGINSKIY P O BOX 242183 MILWAUKEE WI 53224

CBRF CNA Gender - Capacity: M/F - 31 Low/High rate: 2,079/2,938 Initial License: 10/26/1992

Type: Class:

CBRF CNA Gender - Capacity: M/F - 42 Low/High rate: 5,420/6,220 Initial License: 08/17/1989

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,770/6,020 Initial License: 08/09/1993

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,950/4,500 Initial License: 04/15/2011

Type: Class:

CASTLE GARDENS (0011971) 5900 S 92ND ST HALES CORNERS WI 53130 (414) 529-8558 KRISTOPHER KIEFER County: MILWAUKEE

CASTLE HOME CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,618/4,400 Initial License: 05/30/2007

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 66

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,800/4,200 Initial License: 10/12/2009

Type: Class:

CASTLE RIDGE (0013008) 10133 BROOKSIDE DR HALES CORNERS WI 53130 (414) 427-1655 KRISTOPHER KIEFER County: MILWAUKEE

CASTLE HOME CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228

CHAI POINT ASSISTED LIVING (310190) 1400 N PROSPECT AVE MILWAUKEE WI 53202 (414) 289-9600 DEBORAH ZEMEL County: MILWAUKEE CLA SOUTH 44TH STREET (0011256) 2517 S 44TH ST MILWAUKEE WI 53219 (414) 546-1823 JOANNE ZUTZ County: MILWAUKEE CLA WEST ARTHUR (0011254) 6524 W ARTHUR AVE WEST ALLIS WI 53219 (414) 328-0760 JOANNE ZUTZ County: MILWAUKEE CONGRESS PLACE (0013291) 9025 W CONGRESS ST MILWAUKEE WI 53225 (414) 745-3053 MICHAEL ROGINSKIY County: MILWAUKEE

PROSPECT CONGREGATE HOUSING INC (414) 289-9600 DEBORAH ZEMEL 1400 N PROSPECT AVE MILWAUKEE WI 53202 COMMUNITY LIVING ARRANGEMENTS INC (262) 723-8392 JOANNE ZUTZ PO BOX 200 ELKHORN WI 53121 COMMUNITY LIVING ARRANGEMENTS INC (262) 723-8392 JOANNE ZUTZ PO BOX 200 ELKHORN WI 53121 AURORA HOME CARE LLC (414) 745-3053 MICHAEL ROGINSKIY P O BOX 242183 MILWAUKEE WI 53224

CBRF CNA Gender - Capacity: M/F - 38 Low/High rate: 2,374/3,550 Initial License: 03/28/1994

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 24,336/34,064 Initial License: 10/09/2006

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED

CBRF CNA Gender - Capacity: F - 5 Low/High rate: 3,258/4,659 Initial License: 11/09/2006

Type: Class:

CBRF ANA Gender - Capacity: M/F - 8 Low/High rate: 2,950/4,500 Initial License: 09/28/2010

Type: Class:

COUNTRY VIEW (0011567) 10507 S CHICAGO AVE OAK CREEK WI 53154 (414) 764-3303 BOB KRUG County: MILWAUKEE COUNTRYSIDE MANOR (0009425) 4232 W MINNESOTA CT FRANKLIN WI 53132 (414) 423-1802 DAN HOECHERL County: MILWAUKEE

GOLDEN OAK CREST LLC (414) 764-3303 JOHN TERESINSKI 18110 W BLUEMOUND ROAD #4 LWR BROOKFIELD WI 53045 LIFECARE SOLUTIONS INC (414) 628-2535 DEBRA HOECHERL 6497 WHITNALL EDGE RD FRANKLIN WI 53132

Gender - Capacity:

CBRF CNA M/F - 50 Low/High rate: 2,200/3,700 Initial License: 08/29/2006

Type: Class: Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,281/3,281 Initial License: 11/26/2001

COUNTY LINE HOME (0010876) 9589 N 67TH ST BROWN DEER WI 53223 (414) 355-5048 SCOTT WILDER County: MILWAUKEE COVENTRY GROUP HOME (0012149) 8028 W COVENTRY DR FRANKLIN WI 53132 (414) 425-9961 JILL VAN CALSTER County: MILWAUKEE COZY CARE GROUP HOME (310152) 4218 N 36TH ST MILWAUKEE WI 53209 (414) 449-0534 JACQUELINE GARRISON County: MILWAUKEE

MT CASTLE CORPORATION (414) 540-6479 SCOTT WILDER 3808 W ELM ST MILWAUKEE WI 53209 CURATIVE CARE NETWORK (414) 479-9411 JILL VAN CALSTER 1000 N 92ND ST MILWAUKEE WI 53226 COZY CARE CORPORATION (262) 377-8284 JACQUELINE GARRISON 1183 ASPEN CT GRAFTON WI 53024-9366

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 2,200/2,500 Initial License: 05/23/2005

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 5,367/6,996 Initial License: 11/16/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 3,282/3,282 Initial License: 02/01/1992

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 67

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,809/2,809 Initial License: 10/01/2008

Type: Class:

CREATIVE LIVING ENVIRONMENTS AUTUMN VILLA (0012 2904 S 114TH ST WEST ALLIS WI 53227 (414) 543-7080 LAURIE HINTZ County: MILWAUKEE

CREATIVE LIVING ENVIRONMENTS (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094

CREATIVE LIVING ENVIRONMENTS LAYTON COURT (001 12320 W LAYTON AVE GREENFIELD WI 53228 (414) 425-8777 LAURIE HINTZ County: MILWAUKEE

CREATIVE LIVING ENVIRONMENTS (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,786/2,786 Initial License: 10/10/2008

Type: Class:

CREATIVE LIVING ENVIRONMENTS WASHINGTON HEIGH ( CREATIVE LIVING ENVIRONMENTS (920) 261-1345 4926 W WASHINGTON BLVD LUANNE BARNET MILWAUKEE WI 53208 314 E MAIN ST (414) 258-3777 LAURIE HINTZ WATERTOWN WI 53094 County: MILWAUKEE

CBRF ANA Gender - Capacity: M/F - 11 Low/High rate: 2,693/2,693 Initial License: 10/01/2008

Type: Class:

CREEK SIDE MANOR (0012788) 8841 S 13TH ST OAK CREEK WI 53154 (414) 764-1970 WENDY SIEVERT County: MILWAUKEE CREEK SIDE TERRACE (0013958) 8861 S 13TH ST OAK CREEK WI 53154 (414) 856-9300 WENDY SIEVERT County: MILWAUKEE CREST HOUSE (0011361) 3829 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 (414) 762-3838 JARED HOUCK County: MILWAUKEE CRISIS RESOURCE CENTER (0012729) 2057 S 14TH ST MILWAUKEE WI 53204 (414) 643-8778 DAN BAKER County: MILWAUKEE CRU GROUP HOME BAYSIDE MANOR (0009511) 9010 N PORT WASHINGTON RD BAYSIDE WI 53217 (414) 247-3763 GALINA DONETS County: MILWAUKEE

CARING ALTERNATIVES LLC (414) 305-9533 WENDY SIEVERT 656 NEWPORT CIRCLE LINDENHURST IL 60046 CARING ALTERNATIVES LLC (414) 305-9533 WENDY SIEVERT 656 NEWPORT CIRCLE LINDENHURST IL 60046 ALC OPERATING LLC (262) 257-8888 MARY ZAK-KOWALCZYK W140N8981 LILLY RD MENOMONEE FALLS WI 53051 TRANSITIONAL LIVING SERVICES INC (414) 476-9631 DAN BAKER 2057 S 14TH ST MILWAUKEE WI 53204 GALINA DONETS (414) 351-5430 GALINA DONETS 9316 N WAVERLY DR BAYSIDE WI 53217

CBRF CNA Gender - Capacity: M/F - 23 Low/High rate: 3,400/4,950 Initial License: 06/17/2009

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PHYSICALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 29 Low/High rate: 3,400/4,500 Initial License: 12/12/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 75 Low/High rate: 2,940/3,780 Initial License: 04/01/2006

Type: Class:

CBRF AA Gender - Capacity: M/F - 15 Low/High rate: 0/0 Initial License: 10/06/2009

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,100/3,600 Initial License: 09/11/2002

Type: Class:

CRU GROUP HOME BAYSIDE MANOR II (0010524) 9020 N PORT WASHINGTON RD BAYSIDE WI 53217 (414) 247-1726 GALINA DONETS County: MILWAUKEE

GALINA DONETS (414) 351-5430 GALINA DONETS 9316 N WAVERLY DR MILWAUKEE WI 53217

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,950/3,500 Initial License: 04/25/2004

Type: Class:

CRU GROUP HOME INC BROWN DEER MANOR (0012325) 8238 N 44TH ST BROWN DEER WI 53209 (414) 351-5430 GALINA DONETS County: MILWAUKEE

CRU GROUP HOME INC (414) 351-5430 GALINA DONETS 9316 N WAVERLY DR MILWAUKEE WI 53217

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,100/3,600 Initial License: 05/22/2008

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 68

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 15 Low/High rate: 2,632/26,625 Initial License: 02/22/1990

Type: Class:

DEWEY CENTER (310122) 1220 DEWEY AVE WAUWATOSA WI 53213 (414) 454-6600 SUSAN HIRSCH County: MILWAUKEE DUNGARVIN WI N 87TH (0013957) 4501-4507 N 87TH ST MILWAUKEE WI 53225 KIM BEQUEST County: MILWAUKEE DUPAR ASSISTED LIVING LLC (0012505) 10135 W HAMPTON AVE MILWAUKEE WI 53225 (414) 536-6411 VERNITA M WILLIS County: MILWAUKEE EASTCASTLE PLACE (0011864) 2429 E BRADFORD AVE MILWAUKEE WI 53211 (414) 963-6151 MARJORIE J GOZDOWIAK County: MILWAUKEE Association Approval: Leading Age ELIANA HOME III (0014242) 7861 S 68TH ST FRANKLIN WI 53132 (414) 235-3417 GAYLE MILLIS County: MILWAUKEE ELIZABETH RESIDENCE NORTH (0009330) 9329 S 48TH ST FRANKLIN WI 53132 (414) 421-4324 EGRISELDA TUJANI County: MILWAUKEE ELIZABETH RESIDENCE OAK CREEK (0013620) 10441 S NICHOLSON RD OAK CREEK WI 53154 (414) 762-5118 RICHARD COURY County: MILWAUKEE ELIZABETH RESIDENCE OF BAYSIDE (0010952) 9289 N PT WASHINGTON RD BAYSIDE WI 53217 (414) 687-0604 RICHARD COURY County: MILWAUKEE ELIZABETH RESIDENCE SOUTH (0010429) 9355 S 48TH ST FRANKLIN WI 53132 (414) 421-3444 EGRISELDA TUJANI County: MILWAUKEE EMERALD CASTLE (0011970) 11125 W LAYTON AVE GREENFIELD WI 53228 (414) 427-0227 KRISTOPHER KIEFER County: MILWAUKEE ESTHERMERE MANOR (0012625) 7000 N 44TH ST MILWAUKEE WI 53223 (414) 334-1225 DEBORAH CROWLEY County: MILWAUKEE

AURORA HEALTH CARE (414) 647-3002 JAMIE LEWISTON 1220 DEWEY AVE WAUWATOSA WI 53213 DUNGARVIN WISCONSIN LLC (608) 316-7666 KIM BEQUEST 10425 W NORTH AVE STE 149 WAUWATOSA WI 53226 DUPAR ASSISTED LIVING LLC (262) 628-7339 DIANE DUPAR 10135 W HAMPTON AVE MILWAUKEE WI 53225 EASTCASTLE PLACE (414) 963-6151 MARJORIE J GOZDOWIAK 2429 E BRADFORD AVE MILWAUKEE WI 53211 A CLEARER VISION LLC (262) 989-2366 GAYLE MILLIS 1006 CEDEAR CREEK ST RACINE WI 53402 ELIZABETH RESIDENCE INC (414) 540-4141 RICHARD COURY 6430 N GREEN BAY RD GLENDALE WI 53209 RICHARD F COURY (414) 687-0604 RICHARD COURY 6340 N GREEN BAY AVE GLENDALE WI 53209 RJJG LLC (414) 421-4524 RICHARD F COURY 6430 N GREEN BAY AVE GLENDALE WI 53209 ELIZABETH RESIDENCE INC (414) 540-4141 RICHARD COURY 6340 N GREEN BAY AVE GLENDALE WI 53209 CASTLE HOME CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228 ESTHER HOUSE INC (THE) (414) 873-0515 DEBORAH CROWLEY 3340 N 49TH ST MILWAUKEE WI 53216

ALCOHOL/DRUG DEPENDENT

CBRF CS Gender - Capacity: M/F - 7 Low/High rate: 23,192/23,192 Initial License: 04/03/2012

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,500/5,500 Initial License: 10/15/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 4,956/5,487 Initial License: 06/14/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,400/5,500 Initial License: 07/12/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 2,794/4,500 Initial License: 07/12/2001

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,000/6,000 Initial License: 03/16/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 52 Low/High rate: 3,500/5,800 Initial License: 06/09/2005

Type: Class:

CBRF CNA Gender - Capacity: M/F - 31 Low/High rate: 3,250/4,500 Initial License: 12/01/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,618/4,900 Initial License: 05/30/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 3,934/4,210 Initial License: 03/31/2009

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 69

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,200/3,200 Initial License: 01/21/1998

Type: Class:

FAMILY FAITH GROUP HOME II (310646) 2530 W VICTORY LN MILWAUKEE WI 53209 (414) 449-5790 HELEN HUGHES County: MILWAUKEE FAMILY HOUSE 1 (310110) 3269 N 11TH ST MILWAUKEE WI 53206 (414) 374-5212 KAREN HIGGINS County: MILWAUKEE

FAMILY FAITH HOME INC (414) 217-8901 HELEN HUGHES 5528 N 52ND ST MILWAUKEE WI 53218 FAMILY HOUSE INC (414) 374-5212 KAREN HIGGINS 3269 N 11TH ST MILWAUKEE WI 53206

DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,783/3,000 Initial License: 11/01/1989

Type: Class:

FAMILY HOUSE 2 (310651) 3271 3273 N 11TH ST MILWAUKEE WI 53206 (414) 374-5212 KAREN HIGGINS County: MILWAUKEE FAMILY HOUSE 5 (310686) 3287 N 11TH ST MILWAUKEE WI 53206 (414) 374-5212 KAREN HIGGINS County: MILWAUKEE FAMILY HOUSE 6 (0009566) 3291 N 11TH ST MILWAUKEE WI 53206 (414) 374-5212 KAREN HIGGINS County: MILWAUKEE FARDALE HOME (0012692) 3031 W FARDALE AVE MILWAUKEE WI 53221 (414) 282-4123 CRYSTAL J MILLER County: MILWAUKEE

FAMILY HOUSE INC (414) 374-5212 KAREN HIGGINS 3269 N 11TH ST MILWAUKEE WI 53206 FAMILY HOUSE INC (414) 374-5212 KAREN HIGGINS 3269 N 11TH ST MILWAUKEE WI 53206 FAMILY HOUSE INC (414) 374-5212 KAREN HIGGINS 3269 N 11TH ST MILWAUKEE WI 53206 FRONTIDA INC (262) 925-9302 CRYSTAL J MILLER 4324 114TH ST PLEASANT PRAIRIE WI 53158

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,322/2,380 Initial License: 08/18/1997

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,574/2,574 Initial License: 03/24/1998

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 3,063/3,063 Initial License: 07/01/2002

Type: Class:

CBRF CS Gender - Capacity: M/F - 20 Low/High rate: 2,650/3,800 Initial License: 04/01/2009

Type: Class:

FINCH HOUSE (0012715) 5762 FINCH LN GREENDALE WI 53129 (414) 421-5592 STACY ENGLUND County: MILWAUKEE

MILOUDI INC (262) 271-0993 SAM HASSAN LAHRACHE W274 S4025 TIMBER TRAIL WAUKESHA WI 53189

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,000/3,300 Initial License: 07/01/2009

Type: Class:

FOX POINT MANOR (0009113) 7450 N PORT WASHINGTON RD FOX POINT WI 53217 (414) 228-1490 GALINA DONETS County: MILWAUKEE

GALINA DONETS (414) 351-5430 GALINA DONETS 9316 N WAVERLY DR MILWAUKEE WI 53217

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 3,100/3,600 Initial License: 12/14/2000

Type: Class:

FOXCROFT CROSSING (0013959) 7220 FOXCROFT CT FRANKLIN WI 53132 (414) 858-9091 CANDACE DAHLKE County: MILWAUKEE

BRYANT HOMES LLC (414) 241-7067 CANDACE DAHLKE 12501 W NEEDHAM DR NEW BERLIN WI 53151

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 0/3,790 Initial License: 01/01/2012

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 70

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 64 Low/High rate: 4,950/5,200 Initial License: 02/27/1997

Type: Class:

FRANCIS HOUSE (310629) 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 (414) 764-4100 CHRYSTAL ROSSO County: MILWAUKEE Association Approval: Leading Age FRANCISCAN GARDENS (0011763) 1000 WILLIAMS AVE SOUTH MILWAUKEE WI 53172 (414) 570-5370 CHRYSTAL ROSSO County: MILWAUKEE Association Approval: Leading Age GENESIS RESIDENTIAL TREATMENT CTR (310290) 2436 N 50TH ST MILWAUKEE WI 53210 (414) 442-5990 PAULINE ORTLOFF County: MILWAUKEE GENESIS WOMENS RESIDENTIAL PROGRAM (310701) 5427 W VILLARD AVE MILWAUKEE WI 53218 (414) 536-3530 PAULINE ORTLOFF County: MILWAUKEE GOLDEN GARDENS (0012911) 8526 W MILL RD MILWAUKEE WI 53225 (414) 940-6608 PEGGY NORDNESS County: MILWAUKEE

FRANCISCAN VILLA OF SOUTH MILWAUKEE IN (414) 764-4100 CHRYSTAL ROSSO 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 FRANCISCAN VILLA OF SOUTH MILWAUKEE IN (414) 764-4100 CHRYSTAL ROSSO 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST #2210 WEST ALLIS WI 53214 GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST #2210 WEST ALLIS WI 53214 GARDEN VIEW PLATINUM LLC (262) 470-5388 KIM JOHNSON 18110 W BLUEMOUND RD #4 LWR BROOKFIELD WI 53045

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 5,000/5,300 Initial License: 05/10/2007

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 87 Low/High rate: 2,019/2,737 Initial License: 01/25/1996

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: F - 24 Low/High rate: 2,738/2,790 Initial License: 10/31/1998

Type: Class:

ALCOHOL/DRUG DEPENDENT

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 2,800/3,700 Initial License: 01/27/2010

Type: Class:

GOLDEN VIEW (0011359) 6526 W BLUEMOUND RD MILWAUKEE WI 53213 (414) 453-3606 BAUMGARTNER SANDRA County: MILWAUKEE GOOD HOPE MANOR MILWAUKEE (0010158) 7070 N 124TH ST MILWAUKEE WI 53224 (414) 358-2578 LINDA WITZLIB County: MILWAUKEE GOOD HOPE MANOR MILWAUKEE II (0011030) 7060 N 124TH STREET MILWAUKEE WI 53224 (414) 358-1750 LINDA J WITZLIB County: MILWAUKEE GRACEFUL LIVING CENTER INC (0012451) 3628 N 41ST ST MILWAUKEE WI 53216 (414) 442-5740 ARDELIA SWIAMS County: MILWAUKEE

GOLDEN VIEW LLC (262) 989-5381 KENNETH P FILLER 6526 W BLUEMOUND RD MILWAUKEE WI 53213 GOOD HOPE MANOR MILWAUKEE LLC (414) 358-1774 LINDA WITZLIB 7060 N 124TH ST MILWAUKEE WI 53224 GOOD HOPE MANOR MILWAUKEE LLC (414) 358-1774 LINDA J WITZLIB 7060 N 124TH STREET MILWAUKEE WI 53224 GRACEFUL LIVING CENTER INC (414) 975-2485 ARDELIA SWIAMS 3917 N 26TH ST MILWAUKEE WI 53206

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 2,500/3,000 Initial License: 03/06/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 7,790/8,049 Initial License: 08/19/2003

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 6,690/9,750 Initial License: 11/02/2005

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,750/3,750 Initial License: 09/17/2008

Type: Class:

GRANTOSA HOME (0011552) 4265 N 104TH ST MILWAUKEE WI 53222 (414) 461-2300 PATTI HANSBURG County: MILWAUKEE

CLOSE TO HOME SENIOR LIVING CENTER (262) 782-5496 PATTI HANSBURG 2882 S 132ND ST NEW BERLIN WI 53151

CBRF CS Gender - Capacity: M/F - 20 Low/High rate: 2,900/3,900 Initial License: 01/10/2007

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 71

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,826/3,384 Initial License: 03/01/1985

Type: Class:

GREENFIELD HOUSE (310062) 10521 W GREENFIELD AVE WEST ALLIS WI 53214 (414) 259-8929 KIM R BEQUEST County: MILWAUKEE GREGG HOME CARE (310101) 2243 S MOUND ST MILWAUKEE WI 53207 (414) 482-1414 BRIAN GREGG County: MILWAUKEE HAMMOND HOUSE (0010416) 3750 E HAMMOND AVE CUDAHY WI 53110 (414) 486-4120 DAN HOECHERL County: MILWAUKEE

TRANSITIONAL LIVING SERVICES INC (414) 476-9675 PEG DUBORD 1040 S 70TH ST MILWAUKEE WI 53214 BRIAN GREGG (414) 482-1414 BRIAN GREGG 2243 S MOUND ST MILWAUKEE WI 53207 INDEPENDENT LIFESTYLES INC (262) 782-6068 DAN HOECHERL 4405 E DEERWOOD DR NEW BERLIN WI 53151-9240

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 7 Low/High rate: 3,106/3,556 Initial License: 02/01/1992

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED

CBRF AS Gender - Capacity: M/F - 18 Low/High rate: 2,881/2,881 Initial License: 11/19/2003

Type: Class:

HAMPTON II (0008666) 7019 W HAMPTON AVE MILWAUKEE WI 53218 (414) 578-1294 RACHEL OEMIG KLEIN County: MILWAUKEE HAMPTON SUPPORTIVE CARE (310631) 4615 W HAMPTON AVE MILWAUKEE WI 53218 (414) 466-6427 SHARON BUTLER County: MILWAUKEE HARBOUR ASSISTED LIVING RESIDENCES (0012469) 5800 MOCKINGBIRD LN GREENDALE WI 53129 (414) 421-9600 ANNA ZAPATA County: MILWAUKEE HARBOUR HOUSE (THE) (0012470) 5900 MOCKINGBIRD LN GREENDALE WI 53129 (414) 421-9600 BETH VUKOBRAT County: MILWAUKEE HARMONY AT BRENWOOD PARK (0009967) 9535 W LOOMIS RD FRANKLIN WI 53132 (414) 448-0800 SUE SOBERALSKI County: MILWAUKEE Association Approval: WiCAL HARWOOD PLACE ASSISTED LIVING (0009947) 8220 W HARWOOD AVE WAUWATOSA WI 53213 (414) 256-6800 DYONNE WILHELM County: MILWAUKEE Association Approval: Leading Age HERITAGE WEST ALLIS HERITAGE 7 LLC (0012725) 7801 W NATIONAL AVE WEST ALLIS WI 53214 (414) 302-9700 CLARE MATHERS County: MILWAUKEE HERMAN HOUSE (0010082) 3700 3702 S HERMAN ST MILWAUKEE WI 53207 (414) 483-0377 HOLLY NYGRO County: MILWAUKEE

COMMUNITY HOMES INC (414) 578-1294 RACHEL OEMIG KLEIN 7019 W HAMPTON AVE MILWAUKEE WI 53218 WILLOW OF PARKVIEW INC (414) 466-6427 SAMUEL BRANDMAN 2711 W HOWARD ST CHICAGO IL 60645-1303 SL HARBOUR VILLAGE LLC (312) 673-4333 STEPHEN J LEVY 111 E WACKER DR SUITE 2200 CHICAGO IL 60601 SL HARBOUR VILLAGE LLC (312) 673-4333 STEPHEN J LEVY 111 E WACKER DR SUITE 2200 CHICAGO IL 60601 HARMONY OF FRANKLIN LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE MENOMONEE FALLS WI 53051 HARWOOD PLACE INC (414) 256-6800 DYONNE WILHELM 8220 W HARWOOD AVE WAUWATOSA WI 53213 MILO PINKERTON (952) 351-4542 CINDY PAULSON 7901 W NATIONAL AVE WEST ALLIS WI 53214 HEALTHSPAN INC (414) 541-4700 LORI PAPROCKI 5520 W FOREST HOME AVE GREENFIELD WI 53220

CBRF AA Gender - Capacity: M - 6 Low/High rate: 3,162/3,684 Initial License: 07/09/1999

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 3,300/3,800 Initial License: 12/02/1996

Type: Class:

CBRF CNA Gender - Capacity: M/F - 48 Low/High rate: 3,850/6,300 Initial License: 09/18/2008

Type: Class:

ADVANCED AGED CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 52 Low/High rate: 4,075/6,900 Initial License: 09/18/2008

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 50 Low/High rate: 2,795/4,295 Initial License: 04/03/2003

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 4,010/5,990 Initial License: 08/04/2003

Type: Class:

ADVANCED AGED PHYSICALLY DISABLED TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 3,600/4,500 Initial License: 10/21/2009

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 3,100/5,500 Initial License: 05/01/2003

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TERMINALLY ILL

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 72

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,680/3,680 Initial License: 08/01/2001

Type: Class:

HIDDEN TERRACE (0009379) 3405 W SYCAMORE FRANKLIN WI 53132 (414) 423-5607 DAN HOECHERL County: MILWAUKEE

LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151-9240

HIL MEADOWLARK HOME (0012377) 5267 MEADOWLARK LN HALES CORNERS WI 53130-1068 (262) 492-1155 SHARON JOHNSON County: MILWAUKEE HIL MENOMONEE RIVER (0009703) 2850 MENOMONEE RIVER PKWY MILWAUKEE WI 53222 (414) 257-0903 SHARON JOHNSON County: MILWAUKEE HIL ROOT RIVER HOUSE (0009705) 2300 S ROOT RIVER PKWY WEST ALLIS WI 53227 (414) 545-4274 SHARON JOHNSON County: MILWAUKEE HIL SUNSET HOME (0011194) 10212 W SUNSET AVE WAUWATOSA WI 53222 (414) 461-0140 SHARON JOHNSON County: MILWAUKEE HIL VIENNA HOME (0009794) 10136 W VIENNA AVE WAUWATOSA WI 53222 (414) 536-5044 SHARON JOHNSON County: MILWAUKEE HIL WHITNALL HOUSE (0009798) 6275 S 106TH ST HALES CORNERS WI 53130 (414) 427-4993 SHARON JOHNSON County: MILWAUKEE HILLCREST HOMES (0010182) 5408 5414 W VLIET ST MILWAUKEE WI 53208 (414) 476-3505 JOE FUCHS County: MILWAUKEE HILLCREST HOMES 44TH (310118) 5210 S 44TH ST GREENFIELD WI 53220-5111 (414) 423-8226 JOE FUCHS County: MILWAUKEE HILLCREST HOMES 75TH (310193) 1467 S 75TH ST WEST ALLIS WI 53214 (414) 476-2928 JOE FUCHS County: MILWAUKEE HOMESTEAD RIDGE ASSISTED LIVING OF BAYSIDE (001 225 E BROWN DEER RD BAYSIDE WI 53217 (414) 540-2324 TERRI WERNER County: MILWAUKEE HOMESTEAD RIDGE ASSISTED LIVING OF GLENDALE (0 6370 N GREEN BAY AVE GLENDALE WI 53209 (414) 540-0101 TERRI WERNER County: MILWAUKEE

HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE. 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HILLCREST HOMES OF WEST ALLIS INC (414) 322-5437 JOSEPH FUCHS 12720 W LISBON RD BROOKFIELD WI 53005 HILLCREST HOMES OF WEST ALLIS INC (414) 322-5437 JOSEPH FUCHS 12720 W LISBON RD BROOKFIELD WI 53005 HILLCREST HOMES INC (414) 322-5437 JOSEPH FUCHS 12720 W LISBON RD BROOKFIELD WI 53005 HOMESTEAD RIDGE ASSISTED LIVING LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT #5 MADISON WI 53713 HOMESTEAD RIDGE ASSISTED LIVING LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT #5 MADISON WI 53713

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 7,092/7,092 Initial License: 09/22/2008

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 6,833/6,833 Initial License: 01/01/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,179/6,179 Initial License: 01/01/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,816/5,816 Initial License: 11/16/2005

Type: Class:

CBRF CA Gender - Capacity: M/F - 6 Low/High rate: 6,179/6,179 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 7,944/7,944 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,010/2,070 Initial License: 11/02/2004

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 1,875/2,010 Initial License: 09/15/1990

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,000/2,200 Initial License: 05/12/1994

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,500/4,600 Initial License: 03/01/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,900/4,600 Initial License: 03/01/2006

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 73

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,400/4,600 Initial License: 03/01/2006

Type: Class:

HOMESTEAD RIDGE MEMORY CARE (0011368) 6378 N GREEN BAY AVE GLENDALE WI 53209 (414) 228-8996 TERRI WERNER County: MILWAUKEE IRIS MANOR (310155) 2339 N 60TH ST WAUWATOSA WI 53210 (414) 778-1222 LINDA SANCHEZ County: MILWAUKEE IVY TERRACE (0010632) 6606 S CRANE DR OAK CREEK WI 53154 (414) 762-5123 WENDY SIEVERT County: MILWAUKEE JACKSON HOUSE (310071) 2956 S 60TH ST MILWAUKEE WI 53219 (414) 327-6374 KIM R BEQUEST County: MILWAUKEE JEFFERSON CREST III YELLOW ROSE (0011678) 8717 W PALMETTO AVE MILWAUKEE WI 53225 (414) 688-7272 DANIEL TAYLOR County: MILWAUKEE

HOMESTEAD RIDGE ASSISTED LIVING LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT #5 MADISON WI 53713 IRIS MANOR INC (414) 778-1222 RUTH BECK 2339 N 60TH ST WAUWATOSA WI 53210 CARING ALTERNATIVES LLC (847) 356-1806 WENDY SIEVERT 656 NEWPORT CIRCLE LINDENHURST IL 60046 TRANSITIONAL LIVING SERVICES INC (414) 476-9675 PEG DUBORD 1040 S 70TH ST MILWAUKEE WI 53214 JEFFERSON CREST LLC (414) 688-7272 DANIEL TAYLOR P O BOX 511325 MILWAUKEE WI 53203

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,330/2,330 Initial License: 09/01/1992

Type: Class:

Gender - Capacity:

CBRF AS M/F - 6 Low/High rate: 3,127/3,400 Initial License: 07/01/2004

Type: Class: Type: Class:

CBRF AS Gender - Capacity: M/F - 15 Low/High rate: 2,300/2,300 Initial License: 12/22/1986 CBRF CA Gender - Capacity: M/F - 5 Low/High rate: 1,700/3,000 Initial License: 03/29/2007

Type: Class:

JOHN H BRENT HOME FOR SENIORS (0011586) 1721 1723 W MEINECKE AVE MILWAUKEE WI 53206 (414) 562-1358 STELLA MILLER County: MILWAUKEE JOSHUA GLOVER CENTER (310085) 2105 N BOOTH ST MILWAUKEE WI 53212 (414) 263-4481 DOUG HINTON County: MILWAUKEE KERZNER HOUSE (310160) 4354-56 N 91ST ST MILWAUKEE WI 53222 (414) 536-4694 CLEMISTINE BARR County: MILWAUKEE KINDREDHEARTS OF BROWN DEER (0009744) 4015 W WOODALE AVE BROWN DEER WI 53209 (414) 355-7272 CATHY BAIRD County: MILWAUKEE KLUG COMMUNITY LIVING (310191) 3161 S 112TH ST WEST ALLIS WI 53227 (262) 903-1746 ERIC KLUG County: MILWAUKEE LAKE POINTE MANOR (310266) 8781 TRAVIS CT FRANKLIN WI 53132 (414) 427-7707 DAN HOECHERL County: MILWAUKEE

MOUNT CARMEL MISSIONARY BAPTIST CHURC (414) 264-2560 DEACON TERRENCE REED 1717 W MEINECKE AVE MILWAUKEE WI 53206 WISCONSIN COMMUNITY SERVICE (414) 271-2512 JEAN PRUSCHA 2105 N BOOTH ST MILWAUKEE WI 53212 HOME LIVING SERVICES INC (414) 536-4694 CLEMISTINE BARR 4354 N 91ST ST MILWAUKEE WI 53222 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 CATHY BAIRD 4015 W WOODALE AVE BROWN DEER WI 53209 KLUG COMMUNITY LIVING (262) 903-1746 ERIC KLUG 945 LAKE GENEVA BLVD LAKE GENEVA WI 53147 LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,755/4,500 Initial License: 04/09/2007

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

Gender - Capacity:

CBRF AA M - 27 Low/High rate: 2,021/2,021 Initial License: 01/31/1983

Type: Class:

Gender - Capacity:

CBRF CS M/F - 7 Low/High rate: 2,966/3,598 Initial License: 01/13/1993

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 3,200/3,950 Initial License: 10/01/2002

Type: Class:

Gender - Capacity:

CBRF AA M/F - 7 Low/High rate: 1,500/3,500 Initial License: 04/27/1994

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CS M/F - 8 Low/High rate: 3,258/3,258 Initial License: 06/12/1995

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 74

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 4,590/5,657 Initial License: 07/06/1998

Type: Class:

LAKE TERRACE MANOR EAST (310706) 6751 S 68TH ST FRANKLIN WI 53132 (414) 525-0290 WENDY HUG County: MILWAUKEE LAKE TERRACE WEST (0008841) 6771 S 68TH ST FRANKLIN WI 53132 (414) 525-2690 WENDY HUG County: MILWAUKEE LAYTON TERRACE (0008596) 9200 W LAYTON AVE GREENFIELD WI 53228 (414) 425-5600 BETH ANDERSON County: MILWAUKEE LIFECARE MANOR (0008891) 4013 S 119TH ST GREENFIELD WI 53228 (414) 545-6587 DAN HOECHERL County: MILWAUKEE

SENIORMINIUMS MANAGEMENT INC (414) 425-9878 JAMES TETZLAFF 6751 S 68TH ST FRANKLIN WI 53132 SENIORMINIUMS MANAGEMENT INC (414) 525-2690 JAMES TETZLAFF 6771 S 68TH ST FRANKLIN WI 53132 LAYTON TERRACE V LLC (262) 548-5965 BETH ANDERSON 1805 KENSINGTON DR WAUKESHA WI 53188 LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 E DEERWOOD DR NEW BERLIN WI 53151-9240

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 3,972/4,940 Initial License: 10/29/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 70 Low/High rate: 2,925/4,295 Initial License: 08/27/1999

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,258/3,258 Initial License: 02/10/2000

Type: Class:

LIGHTHOUSE AT BROWN DEER I (0011461) 7909 N 47TH ST BROWN DEER WI 53223-4475 (414) 354-6110 TYWANA GEORGE County: MILWAUKEE LIGHTHOUSE AT BROWN DEER II (0011459) 7911 N 47TH STREET BROWN DEER WI 53223 (414) 354-8505 TYWANA GEORGE County: MILWAUKEE LINCOLN HOUSE LLC (0012573) 10173 W GRANTOSA DR MILWAUKEE WI 53222 (414) 466-1560 GERALYN VOBORIL County: MILWAUKEE

NEW PERSPECTIVES BROWN DEER LLC (952) 746-3630 TYWANA GEORGE 7911 N 47TH ST BROWN DEER WI 53223 NEW PERSPECTIVES BROWN DEER LLC (952) 746-3630 TYWANA GEORGE 7911 N 47TH ST BROWN DEER WI 53223 LINCOLN HOUSE LLC (414) 466-1560 GERALYN VOBORIL 11115 WEST MEADOWCREEK DRIVE MILWAUKEE WI 53224

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,193/4,910 Initial License: 06/08/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 3,193/4,910 Initial License: 06/08/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,100/6,000 Initial License: 01/05/2009

Type: Class:

LINCOLN TERRACE GROUP HOME (0014399) 2416 S 60TH ST WEST ALLIS WI 53219 (414) 803-3497 VITALIY GORELIK County: MILWAUKEE LUTHER MANOR COURTYARDS (310087) 4611 N 92ND ST WAUWATOSA WI 53225 (414) 464-3880 KRISTY JOHNSON-FOFANAH County: MILWAUKEE Association Approval: Leading Age LUTHERAN HOME ASSISTED LIVING (0010582) 7500 W NORTH AVE WAUWATOSA WI 53213 (414) 258-6170 STEPHANIE LEANES County: MILWAUKEE Association Approval: Leading Age

GOLDEN MILLENNIUM ENTERPRISES LLC (414) 803-3497 VITALIY GORELIK 3701 SHERBROOKE DR MEQUON WI 53092 UNITED LUTHERAN PROGRAM FOR THE AGING (414) 464-3880 DAVID BEINLICH 4545 N 92ND ST MILWAUKEE WI 53225 LUTHERAN HOME INC (THE) (414) 258-6170 STEPHANIE LEANES 7500 W NORTH AVE WAUWATOSA WI 53213

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,481/3,481 Initial License: 12/07/2012

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 164 Low/High rate: 2,600/5,200 Initial License: 11/27/1981

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 4,845/5,600 Initial License: 06/01/2004

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 75

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 31,937/31,937 Initial License: 06/15/2012

Type: Class:

LYNX (0014191) 6188 N 122ND ST MILWAUKEE WI 53225 KIM BEQUEST County: MILWAUKEE MANITOBA GROUP HOME (0014252) 3018 S 9TH ST MILWAUKEE WI 53215 (414) 483-0156 NATHAN ZEIGER County: MILWAUKEE MANITOBA HOUSE (310159) 3037 S 41ST ST MILWAUKEE WI 53215 (414) 384-0431 BUCKLEY MEADE County: MILWAUKEE MARANATHA HOUSE (THE) (0011513) 4567 N 71ST ST MILWAUKEE WI 53218 (414) 873-0515 DEBORAH A CROWLEY County: MILWAUKEE MARANATHA HOUSE SOUTH (THE) (0012681) 2526 S 85TH ST WEST ALLIS WI 53227 (414) 334-1225 DEBORAH CROWLEY County: MILWAUKEE MARANATHA HOUSE TACOMA (THE) (0012162) 6811 N TACOMA ST MILWAUKEE WI 53224-4748 (414) 446-8449 DEBORAH CROWLEY County: MILWAUKEE MARION HOUSE (0012516) 4345 N 91ST ST MILWAUKEE WI 53222 (414) 527-9216 CLEMISTINE BARR County: MILWAUKEE MATT TALBOT RECOVERY CENTER (310016) 2613 W NORTH AVE MILWAUKEE WI 53205 (414) 342-5474 ANTONIO DESHAZOR County: MILWAUKEE MATTHEWS OF MILWAUKEE I (0014182) 7325 N PORT WASHINGTON GLENDALE WI 53217-3416 (414) 540-0405 PAM CROFT County: MILWAUKEE

DUNGARVIN WISCONSIN LLC (608) 316-7666 KIM BEQUEST 10425 W NORTH AVE STE 149 WAUWATOSA WI 53226 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZEIGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218 ODAAT INC (414) 427-4884 BUCKLEY MEADE 9415 W FOREST HOME AVE HALES CORNERS WI 53130 AD2LUV LLC (414) 873-0515 DEBORAH A CROWLEY 3340 N 49TH ST MILWAUKEE WI 53216 AD2LUV LLC (414) 873-0515 DEBORAH CROWLEY 3340 N 49TH ST MILWAUKEE WI 53216 AD2LUV LLC (414) 873-0515 DEBORAH CROWLEY W257 S5208 WOOD LILLY LANE WAUKESHA WI 53189 HOME LIVING SERVICES INC (414) 536-4694 MARGARET MIMS 4354 N 91ST ST MILWAUKEE WI 53222 MATT TALBOT RECOVERY CENTER INC (414) 294-3050 MATT TALBOT RECOVERY CENTER IN P O BOX 20007 GREENFIELD WI 53220 MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST. UNIT 401 CHICAGO IL 60643

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8

Type: Class: Low/High rate:

Initial License:

Type: Class:

12/10/2012

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,285/1,285 Initial License: 12/11/1992 CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,058/3,850 Initial License: 01/07/2007

Type: Class:

ALCOHOL/DRUG DEPENDENT

ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED

CBRF CA Gender - Capacity: M/F - 6 Low/High rate: 3,966/4,200 Initial License: 03/31/2009

Type: Class:

CBRF CA Gender - Capacity: M/F - 5 Low/High rate: 3,646/3,846 Initial License: 02/07/2008

Type: Class:

CBRF CS Gender - Capacity: M/F - 5 Low/High rate: 3,600/3,800 Initial License: 01/27/2009

Type: Class:

CBRF AA Gender - Capacity: M - 26 Low/High rate: 2,418/2,790 Initial License: 12/01/1986

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,020/7,040 Initial License: 06/15/2012

Type: Class:

MATTHEWS OF MILWAUKEE II (0014181) 7335 N PORT WASHINGTON RD GLENDALE WI 53217-3416 (414) 540-0242 PAM CROFT County: MILWAUKEE

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST. UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,020/7,040 Initial License: 06/15/2012

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 76

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,020/5,704 Initial License: 06/15/2012

Type: Class:

MATTHEWS OF OAK CREEK (0014183) 7550 S 13TH ST OAK CREEK WI 53154 (414) 768-8889 ROTH WEAVER County: MILWAUKEE

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST. UNIT 401 CHICAGO IL 60643

MATTHEWS OF SAINT FRANCIS I (0014180) 3660 E DENTON AVE ST FRANCIS WI 53235-5951 (414) 486-1008 TRISH KOVACS County: MILWAUKEE

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST. UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,020/5,704 Initial License: 06/15/2012

Type: Class:

MAXSON MANOR (0009569) 11250 W COLDSPRING RD GREENFIELD WI 53228 (414) 427-7857 KIMBERLY NUNN County: MILWAUKEE META HOUSE (310697) 2618 N BREMEN ST MILWAUKEE WI 53212 (414) 962-1200 CHRISTINE A ULLSTRUP County: MILWAUKEE META HOUSE III (310026) 3924 3926 N MARYLAND AVE SHOREWOOD WI 53211 (414) 962-6577 CHRISTINE ULLSTRUP County: MILWAUKEE META HOUSE RIVERWEST CAMPUS NORTH (310044) 2626 N BREMEN ST MILWAUKEE WI 53212 (414) 962-1200 CHRISTINE ULLSTRUP County: MILWAUKEE MICHELE HOME (0012694) 8919 N MICHELE ST MILWAUKEE WI 53224 (414) 355-2121 CRYSTAL J MILLER County: MILWAUKEE

MAXSON MANOR INC (414) 427-7857 SCOTT CHAPPELL 4719 KINGDOM CT RACINE WI 53402 META HOUSE INC (414) 962-1200 AMY LINDNER 2625 N WEIL ST MILWAUKEE WI 53212 META HOUSE INC (414) 962-1200 FRANCINE FEINBERG PO BOX 11564 MILWAUKEE WI 53211-0564 META HOUSE INC (414) 962-1200 CHRISTINE ULLSTRUP 2618 N BREMEN MILWAUKEE WI 53212 FRONTIDA INC (262) 925-9302 CRYSTAL J MILLER 4324 114TH ST PLEASANT PRAIRIE WI 53158

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 3,100/3,300 Initial License: 06/17/2002

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 15 Low/High rate: 2,981/3,787 Initial License: 05/15/1998

Type: Class:

Gender - Capacity:

CBRF AA F-8 Low/High rate: 3,735/4,185 Initial License: 11/30/1984

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

Gender - Capacity:

CBRF AA F - 20 Low/High rate: 3,486/4,185 Initial License: 04/01/1988

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

Gender - Capacity:

CBRF CS M/F - 20 Low/High rate: 2,600/4,000 Initial License: 04/01/2009

Type: Class:

MIDLAND TERRACE (0008521) 5128 W MIDLAND DR GREENFIELD WI 53220 (414) 545-0660 DAN HOECHERL County: MILWAUKEE

LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,279/3,279 Initial License: 02/05/1999

Type: Class:

MILWAUKEE WOMENS CENTER HORIZON CAMPUS (001 2511 W VINE ST MILWAUKEE WI 53205 (414) 342-3237 LATRICE BUCK County: MILWAUKEE MITCHELL MANOR - OAK CREEK (0012247) 8740 S OAK PARK DR OAK CREEK WI 53154 (414) 766-2100 MICHAEL BANGS County: MILWAUKEE

COMMUNITY ADVOCATES INC (414) 449-4777 LATRICE BUCK 728 N JAMES LOVELL ST MILWAUKEE WI 53233 FIVE STAR QUALITY CARE WI LLC (617) 796-8387 MICHAEL BANGS 701 E PUETZ RD OAK CREEK WI 53154

CBRF AA Gender - Capacity: M/F - 15 Low/High rate: 2,190/2,370 Initial License: 01/27/2010

Type: Class:

ADVANCED AGED CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 4,193/4,606 Initial License: 01/18/2008

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 77

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 70 Low/High rate: 3,810/4,620 Initial License: 01/18/2008

Type: Class:

MITCHELL MANOR WEST ALLIS (0012245) 5301 W LINCOLN AVE WEST ALLIS WI 53219 (414) 615-7200 FRANCESCA LO CICERO County: MILWAUKEE MORGAN HOUSE (310064) 3749 3751 S 80TH ST MILWAUKEE WI 53220 (414) 327-5121 KIM R BEQUEST County: MILWAUKEE NORTH 66TH ST (0010149) 8484 N 66TH ST BROWN DEER WI 53223 (414) 371-1488 RICHARD HINTZ County: MILWAUKEE NORTH SHORE HOUSE (0012761) 6807 N SANTA MONICA BLVD FOX POINT WI 53217 (414) 351-9207 STACY ENGLUND County: MILWAUKEE

FIVE STAR QUALITY CARE WI LLC (617) 796-8387 FRANCESCA LO CICERO 5301 W LINCOLN AVE WEST ALLIS WI 53219 TRANSITIONAL LIVING SERVICES INC (414) 476-9675 PEG DUBORD 1040 S 70TH ST MILWAUKEE WI 53214 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 MILOUDI INC (262) 271-0993 SAM HASSAN LAHRACHE W274 S4025 TIMBER TRAIL WAUKESHA WI 53189

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,333/3,333 Initial License: 05/01/1985

Type: Class:

CBRF CNA Gender - Capacity: F - 6 Low/High rate: 6,659/6,659 Initial License: 12/01/2003

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,000/3,300 Initial License: 07/01/2009

Type: Class:

OAK CREST BLAKEWOOD HOME (310275) 3407 S BLAKEWOOD AVE SOUTH MILWAUKEE WI 53172 (414) 764-2760 MICHELLE RINGWOLSKI County: MILWAUKEE OAK CREST FRANKLIN HOME (310628) 7599 FRANCIS CT FRANKLIN WI 53132 (414) 427-4135 MICHELLE RINGWOLSKI County: MILWAUKEE OAK CREST VILLA (310129) 8765 W FOREST HOME AVE GREENFIELD WI 53228 (414) 427-0744 MICHELLE RINGWOLSKI County: MILWAUKEE OAK PARK PLACE WAUWATOSA (0014395) 1621 RIVERS BEND WAUWATOSA WI 53226 (414) 292-0400 TONI CARRUTHERS County: MILWAUKEE OAK RIDGE HOUSE (0012760) 2630 N 118TH ST WAUWATOSA WI 53226 (414) 258-6355 STACY ENGLUND County: MILWAUKEE OAKWOOD TERRACE (0008884) 1110 W OAKWOOD RD OAK CREEK WI 53154 (414) 766-0915 BETH DESAI County: MILWAUKEE OHIO HOUSE (0008786) 3309 S 112TH ST WEST ALLIS WI 53227 (414) 541-1352 KIM R BEQUEST County: MILWAUKEE OKLAHOMA GROUP HOME (0012672) 3245 S 24TH ST MILWAUKEE WI 53215 (414) 671-6965 NATHAN ZIEGLER County: MILWAUKEE

OAK CREST BLAKEWOOD HOME INC (414) 427-0744 MICHELLE RINGWOLSKI 8765 W FOREST HOME AVE GREENFIELD WI 53228 OAK CREST BLAKEWOOD HOME INC (414) 427-0744 MICHELLE RINGWOLSKI 8765 W FOREST HOME AVE GREENFIELD WI 53228 OAK CREST VILLA INC (414) 427-0744 MICHELLE RINGWOLSKI 8765 W FOREST HOME AVE GREENFIELD WI 53228 OAK PARK PLACE OF WAUWATOSA LLC (608) 663-8728 TONI CARRUTHERS 719 JUPITER DR MADISON WI 53718 MILOUDI INC (262) 271-0993 SAM HASSAN LAHRACHE W274 S4025 TIMBER TRAIL WAUKESHA WI 53189 OAKWOOD TERRACE INC (414) 766-0915 JODEE CHAPPELL 8735 S 6TH AVE OAK CREEK WI 53154 TRANSITIONAL LIVING SERVICES INC (414) 476-9675 PEG DUBORD 1040 S 70TH ST MILWAUKEE WI 53214 PHOENIX CARE SYSTEMS INC (414) 225-4460 NATHAN ZIEGER 5151 W SILVER SPRING DR MILWAUKEE WI 53218

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,000/4,500 Initial License: 08/05/1994

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 4,250/4,500 Initial License: 12/17/1996

Type: Class:

CBRF CNA Gender - Capacity: M/F - 42 Low/High rate: 3,064/4,500 Initial License: 12/01/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 5,148/6,120 Initial License: 11/26/2012

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,000/3,300 Initial License: 07/01/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,800/3,100 Initial License: 12/03/1999

Type: Class:

CBRF AA Gender - Capacity: M - 8 Low/High rate: 3,061/3,061 Initial License: 08/17/1999

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 38,263/38,263 Initial License: 05/01/2009

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 78

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,900/3,800 Initial License: 06/03/2005

Type: Class:

PARK HILLS WEST (0010918) 5910 S 118TH ST HALES CORNERS WI 53130 (414) 425-2449 ELAINE K LUKAS County: MILWAUKEE PARKWAY HOUSE (0012752) 2780 N MENOMONEE RIVER PKWY MILWAUKEE WI 53222 (414) 771-7326 STACY ENGLUND County: MILWAUKEE

PARK HILLS WEST LLC (262) 513-1242 ELAINE K LUKAS 529 COUNTRY CREST LN WAUKESHA WI 53188 MILOUDI INC (262) 271-0993 SAM HASSAN LAHRACHE W274 S4025 TIMBER TRAIL WAUKESHA WI 53189

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,000/3,300 Initial License: 07/01/2009

Type: Class:

PARSONS HOUSE (310022) 2930 N 25TH ST MILWAUKEE WI 53206 (414) 445-3301 JULIUS COATES County: MILWAUKEE PEACE RESIDENTIAL HOME (310223) 6477 N 91ST ST MILWAUKEE WI 53224 (414) 353-4441 DONNA VORPAGEL County: MILWAUKEE PINE HAVEN (0011114) 6795 S 51ST ST FRANKLIN WI 53132 (414) 421-8010 DAN HOECHERL County: MILWAUKEE

WISCONSIN COMMUNITY SERVICES INC (414) 290-0400 JOSEPH SPOLOWICZ 3732 W WISCONSIN AVE SUITE 200 MILWAUKEE WI 53208 PEACE RESIDENTIAL HOME INC (414) 353-4441 DONNA VORPAGEL 6477 N 91ST ST MILWAUKEE WI 53224 INDEPENDENT LIFESTYLES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151-9240

CBRF AA Gender - Capacity: M/F - 40 Low/High rate: 0/2,708 Initial License: 05/24/1983

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING CORRECTIONAL CLIENTS

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,184/2,586 Initial License: 01/10/1995

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,390/3,456 Initial License: 02/01/2006

Type: Class:

POSITIVE LIVING SERVICES INC (0011759) 7072 N 37TH ST MILWAUKEE WI 53209 (414) 247-0037 SHIRLEY M HARRIS County: MILWAUKEE PRESTIGIOUS ACADEMY INC (0010546) 2624 N 16TH ST MILWAUKEE WI 53206 (414) 265-8181 VERDELLA HARVEY County: MILWAUKEE PRESTIGIOUS ACADEMY INC II (0011926) 2628 N 16TH ST MILWAUKEE WI 53206 (414) 265-8181 VERDELLA HARVEY County: MILWAUKEE PRIMROSE RESIDENTIAL FACILITY (0009366) 3910 3910A W BURLEIGH ST MILWAUKEE WI 53210 (414) 445-3607 SHIRLEY GLADNEY County: MILWAUKEE PROSPECT PLACE (310230) 1825 N PROSPECT AVE MILWAUKEE WI 53202 (414) 298-8600 HEATHER V FRIESS County: MILWAUKEE

POSITIVE LIVING SERVICES INC (414) 627-2881 SHIRLEY M HARRIS 3611 W HIGHLAND BLVD MILWAUKEE WI 53208 VERDELLA HARVEY (414) 265-8181 VERDELLA HARVEY PO BOX 6468 MILWAUKEE WI 53206 VERDELLA HARVEY (414) 247-9444 VERDELLA HARVEY PO BOX 6468 MILWAUKEE WI 53209 SHIRLEY GLADNEY (414) 462-0802 SHIRLEY GLADNEY 3910 W BURLEIGH ST MILWAUKEE WI 53210 COMMUNITY CARE ORGANIZATION INC (414) 298-8600 HEATHER V FRIESS 1825 N PROSPECT AVE MILWAUKEE WI 53202

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 2,750/3,750 Initial License: 06/25/2007

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,600/4,200 Initial License: 01/05/2005

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,750/3,750 Initial License: 08/04/2008

Type: Class: Type: Class:

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 3,500/4,000 Initial License: 04/05/2002 CBRF CNA Gender - Capacity: M/F - 76 Low/High rate: 2,250/2,250 Initial License: 10/10/1994

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 79

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,077/3,078 Initial License: 03/28/1994

Type: Class:

RAINBOW PARK HOME (310189) 1217 S 118TH ST WEST ALLIS WI 53214 (414) 257-1208 DAWN KENNISON County: MILWAUKEE RAMSEY WOODS RESIDENCE (310247) 3210 E RAMSEY AVE CUDAHY WI 53110 (414) 744-4663 JOANNE SWANSON County: MILWAUKEE RAVENSWOOD MANOR (310622) 8454 RAVENSWOOD CIRCLE WAUWATOSA WI 53226 (414) 443-0646 DAN HOECHERL County: MILWAUKEE

DEK COMPANY INC (414) 438-6620 DAWN E KENNISON 4473 N 105TH ST WAUWATOSA WI 53225 FAMILY LIVING SERVICES INC (414) 744-4663 JOANNE SWANSON 6430 N GREEN BAY AVE GLENDALE WI 53209-0000 INDEPENDENT LIFESTYLES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151

Gender - Capacity:

CBRF CNA M/F - 33 Low/High rate: 2,794/5,000 Initial License: 03/17/1995

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CS M/F - 8 Low/High rate: 3,148/3,148 Initial License: 11/18/1996

Type: Class:

REM WISCONSIN II INC COLLEGE AVE (0010402) 3177 W COLLEGE AVE FRANKLIN WI 53132 (414) 761-1943 SHELLEY HANSEN-BLAKE County: MILWAUKEE REM WISCONSIN II INC NICHOLSON (0010403) 1009 NICHOLSON AVE SOUTH MILWAUKEE WI 53172 (414) 768-5554 SHELLEY HANSEN-BLAKE County: MILWAUKEE RESIDENTIAL LIVING SERVICES (310204) 1628 N 19TH ST MILWAUKEE WI 53205 (414) 342-9324 JOANN HARRIS County: MILWAUKEE RESIDENTIAL LIVING SERVICES II (310271) 1624 N 19TH ST MILWAUKEE WI 53205 (414) 345-8243 JOANN HARRIS County: MILWAUKEE RIVERSIDE TERRACE (0008995) 5883 W RIVERSIDE DR GREENDALE WI 53129 (414) 423-4289 DAN HOECHERL County: MILWAUKEE ROBINWOOD MANOR (310234) 10520 W ROBINWOOD LN FRANKLIN WI 53132 (414) 427-9959 DAN HOECHERL County: MILWAUKEE SERENITY SPRINGS (0013182) 5636 N 80TH ST MILWAUKEE WI 53218 (414) 231-9073 FLOWER LEWIS County: MILWAUKEE SHEPARD AVENUE GROUP HOME (310671) 8860 S SHEPARD AVE OAK CREEK WI 53154 (414) 762-2321 GWENDOLYN DUNKIN County: MILWAUKEE

REM WISCONSIN II INC (608) 276-1192 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HIGHWAY #203 MADISON WI 53713 REM WISCONSIN II INC (608) 276-1191 SHELLEY HANSEN BLAKE 2005 W BELTLINE HIGHWAY #203 MADISON WI 53713 RESIDENTIAL LIVING SERVICES INC (414) 345-8243 JOANN HARRIS PO BOX 05613 MILWAUKEE WI 53205 RESIDENTIAL LIVING SERVICES INC (414) 933-3929 JOANN HARRIS PO BOX 05613 MILWAUKEE WI 53205 LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151 LIFECARE HOMES INC (262) 782-6068 DAN HOECHERL 4405 S DEERWOOD DR NEW BERLIN WI 53151 FLOWER LEWIS (414) 915-8150 FLOWER LEWIS 7829 W BECKETT AVE MILWAUKEE WI 53218 LUTHERAN SOC SERV OF WI & UPPER MI INC (262) 896-3446 TED HAKALA 3003 N RICHMOND ST APPLETON WI 54911

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 7,551/9,367 Initial License: 09/13/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,947/6,219 Initial License: 12/26/2003

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 7 Low/High rate: 3,300/3,300 Initial License: 09/15/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 3,300/3,300 Initial License: 03/03/1998

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,741/3,741 Initial License: 05/12/2000

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,222/3,222 Initial License: 12/02/1994

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,750/3,300 Initial License: 02/03/2011

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 2,775/3,500 Initial License: 10/01/1997

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 80

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,800/4,200 Initial License: 10/12/2009

Type: Class:

SIENNA CASTLE (0013007) 9640 W LAYTON AVE GREENFIELD WI 53220 (414) 427-1655 KRISTOPHER KIEFER County: MILWAUKEE

CASTLE HOME CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228

SILVER VIEW LLC (0012742) 9215 W SILVER SPRING DR MILWAUKEE WI 53222 (414) 461-2033 BRIDGETTE GUY County: MILWAUKEE

SILVER VIEW LLC (262) 470-5388 JEROME ALTON 18110 W BLUEMOUND RD #4 BROOKFIELD WI 53045

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,800/3,700 Initial License: 04/08/2009

Type: Class:

SKY RESIDENTIAL FRANKLIN (0012151) 8104 S 35TH ST FRANKLIN WI 53132 (414) 421-1886 KIM NGUYEN County: MILWAUKEE

SKY RESIDENTIAL SERVICES INC (414) 534-2979 KIM NGUYEN N94 W20846 SCHLEI RD MENOMONEE FALLS WI 53051

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,740/7,750 Initial License: 11/01/2007

Type: Class:

SOUTH 47TH STREET (310009) 1015 1017 S 47TH ST WEST MILWAUKEE WI 53214 (414) 645-0588 RICHARD HINTZ County: MILWAUKEE SOUTH MILWAUKEE (0010134) 1408 MARION SOUTH MILWAUKEE WI 53172-3010 (414) 762-8060 LESLEY SILBERHORN County: MILWAUKEE SOUTH SHORE HOUSE (310294) 6168 S SWIFT AVE CUDAHY WI 53110 (414) 762-6005 TAMMY BISHOP County: MILWAUKEE ST ANNES HOME FOR THE ELDERLY CBRF (0012345) 3800 N 92ND ST MILWAUKEE WI 53222 (414) 463-7570 PAMELA SOMERS County: MILWAUKEE Association Approval: Leading Age ST CAMILLUS (0011293) 10101 W WISCONSIN AVE WAUWATOSA WI 53226 (414) 258-1814 DAVID TANCK County: MILWAUKEE ST JOHNS MANOR (310144) 812 MARQUETTE AVE SOUTH MILWAUKEE WI 53172 (414) 762-2511 ELLEN LICHTE County: MILWAUKEE ST MARYS MANOR (310235) 1313 MISSOURI AVE SOUTH MILWAUKEE WI 53172 (414) 762-8026 ELLEN LICHTE County: MILWAUKEE

CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 LUTHERAN SOC SERV OF WI & UPPER MI INC (262) 896-3446 TED HAKALA 3003 N RICHMOND ST APPLETON WI 54911 CARING ALTERNATIVES LLC (414) 305-9533 WENDY SIEVERT 656 NEWPORT CIRCLE LINDENHURST IL 60046-6742 ST ANNES HOME FOR THE ELDERLY MILWAUK (414) 463-7570 LYNN VOGT 3800 N 92ND ST MILWAUKEE WI 53222 SAN CAMILLO INC (414) 258-1814 MARIE D'AMICO 10101 W WISCONSIN AVE WAUWATOSA WI 53226 COMMUNITY LIVING CENTERS INC (414) 762-8026 ELLEN LICHTE 1313 MISSOURI AVE SOUTH MILWAUKEE WI 53172 COMMUNITY LIVING CENTERS INC (414) 762-8026 ELLEN LICHTE 1313 MISSOURI AVE SOUTH MILWAUKEE WI 53172

CBRF AA Gender - Capacity: F - 6 Low/High rate: 4,415/4,415 Initial License: 01/01/1981

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 5 Low/High rate: 5,160/5,160 Initial License: 07/21/2003

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,900/3,600 Initial License: 03/23/1996

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 55 Low/High rate: 3,600/5,200 Initial License: 03/31/2009

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 86 Low/High rate: 4,360/6,085 Initial License: 01/12/2006

Type: Class:

ADVANCED AGED

CBRF CS Gender - Capacity: M/F - 27 Low/High rate: 3,000/3,400 Initial License: 10/08/1991

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,000/3,300 Initial License: 02/03/1995

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 81

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 7,898/7,898 Initial License: 06/21/2012

Type: Class:

STONERIDGE (0014217) 8511 N STONERIDGE CT BROWN DEER WI 53223 (414) 586-0012 BRAD ZWICKER County: MILWAUKEE SULLIVAN HOUSE ST FRANCIS (310298) 3652 S RUTLAND AVE ST FRANCIS WI 53235 (414) 761-1390 KATHLEEN A SULLIVAN County: MILWAUKEE SUPPORTIVE CARE LLC (0012301) 4630 N HOPKINS ST MILWAUKEE WI 53209 (414) 442-6270 DELOIS C JOHNSON County: MILWAUKEE SYLVAN CROSSINGS AT CREEKSIDE ESTATES (0009038) 6180 S CREEKSIDE DR CUDAHY WI 53110 (414) 762-7408 LISA FREI County: MILWAUKEE TALL OAKS OF WEST ALLIS (0008617) 2825 S WAUKESHA RD WEST ALLIS WI 53227 (414) 321-7101 JOHN BECHERER County: MILWAUKEE THURGOOD MARSHALL HOUSE (310137) 1914 N 6TH ST MILWAUKEE WI 53212 (414) 264-7447 DOUG HINTON County: MILWAUKEE TRINITY HEALTH CARE INC (0009472) 5605 W CUSTER AVE MILWAUKEE WI 53218 (414) 466-6664 FOLAKE ROSE ADENIYI County: MILWAUKEE UNITED COMMUNITY CENTER ART 1 (0012894) 604 W SCOTT ST MILWAUKEE WI 53204 (414) 643-8530 RENE FARIAS County: MILWAUKEE

WITZLIB HOLDINGS LLC (414) 708-4802 LINDA WITZLIB 7060 N 124TH ST MILWAUKEE WI 53224 SULLIVAN HOUSE ST FRANCIS INC (414) 761-1390 KATHLEEN A SULLIVAN 2360 W CRABAPPLE LANE UNIT 2 OAK CREEK WI 53154 SUPPORTIVE CARE LLC (414) 442-6270 DELOIS C JOHNSON 4630 N HOPKINS ST MILWAUKEE WI 53209 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE MADISON WI 53711 NORTH AMERICAN HEALTH CARE LLC (414) 321-7101 JOHN BECHERER 2825 S. WAUKESHA RD WEST ALLIS WI 53227 WISCONSIN COMMUNITY SERVICES INC (414) 290-0400 JOSEPH SPOLOWICZ 3732 W WISCONSIN AVE SUITE 200 MILWAUKEE WI 53208 TRINITY HEALTH CARE INC (414) 466-6664 FOLAKE ROSE ADENIYI 5605 W CUSTER AVE MILWAUKEE WI 53218 UNITED COMMUNITY CENTER INC (414) 384-3100 RENE FARIAS 1028 S 9TH ST MILWAUKEE WI 53204

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 2,729/2,976 Initial License: 08/12/1996

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED

CBRF CS Gender - Capacity: M - 5 Low/High rate: 2,850/3,500 Initial License: 02/25/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,200/5,200 Initial License: 09/30/2000

Type: Class:

CBRF CS Gender - Capacity: M/F - 20 Low/High rate: 2,550/3,500 Initial License: 05/06/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M - 26 Low/High rate: 0/0 Initial License: 07/15/1991

Type: Class:

CBRF CNA Gender - Capacity: F - 7 Low/High rate: 3,151/3,900 Initial License: 01/23/2002

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 15 Low/High rate: 4,440/4,440 Initial License: 08/13/2009

Type: Class:

UNITED COMMUNITY CENTER LATINAS UNIDAS (0009410) UNITED COMMUNITY CENTER INC (414) 384-3100 1007 S 8TH ST RENE FARIAS MILWAUKEE WI 53204 1111 S 6TH ST (414) 649-0189 RENE FARIAS MILWAUKEE WI 53204 County: MILWAUKEE UNITED COMMUNITY CTR ADULT RESIDENTIAL TRMT (31 1011 S 8TH ST MILWAUKEE WI 53204 (414) 649-4413 RENE FARIAS County: MILWAUKEE VILLA ST FRANCIS (310120) 1910 W OHIO AVE MILWAUKEE WI 53215 (414) 649-2888 PAMELA GANSMANN County: MILWAUKEE Association Approval: WALA VILLAGE AT MANOR PARK PALMER HOUSE (310053) 3023 S 84TH ST WEST ALLIS WI 53227 (414) 607-4100 SUE L PROSTKO County: MILWAUKEE Association Approval: Leading Age UNITED COMMUNITY CENTER INC (414) 384-3100 RENE FARIAS 1028 S 9TH ST MILWAUKEE WI 53204 VILLA ST FRANCIS INC (414) 649-2888 PAMELA GANSMANN 1910 W OHIO AVE MILWAUKEE WI 53215 METHODIST MANOR INC (414) 607-4100 SUE L PROSTKO 3023 S 84TH ST WEST ALLIS WI 53227

CBRF AA Gender - Capacity: F - 17 Low/High rate: 5,250/5,250 Initial License: 10/29/2001

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 8 Low/High rate: 2,130/4,562 Initial License: 10/26/1991

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 134 Low/High rate: 1,335/3,650 Initial License: 10/18/1990

Type: Class:

ADVANCED AGED PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS

CBRF CNA Gender - Capacity: M/F - 130 Low/High rate: 3,197/3,932 Initial License: 04/01/1980

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 82

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 20 Low/High rate: 2,600/3,800 Initial License: 04/01/2009

Type: Class:

WABASH HOME (0012695) 7716 W WABASH CT MILWAUKEE WI 53224 (414) 354-8408 LULA WALLS County: MILWAUKEE

FRONTIDA INC (262) 925-9302 CRYSTAL J MILLER 4324 114TH ST PLEASANT PRAIRIE WI 53158

WAHNER HOUSE (310648) 5765 W WAHNER DR BROWN DEER WI 53223 (414) 355-3364 WENDY DOUGLAS County: MILWAUKEE WASHINGTON HEIGHTS MANOR (0012706) 1506 1510 N 48TH ST MILWAUKEE WI 53208 (262) 389-1461 RAKESH/SHANNON PATEL County: MILWAUKEE

MT CASTLE CORPORATION (414) 540-6479 SCOTT WILDER 3808 W ELM ST MILWAUKEE WI 53209 WORLDWIDE ESTATE INC (262) 389-1461 RAKESH PATEL PO BOX 601 BUTLER WI 53007

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 3,000/3,700 Initial License: 10/02/1997

Type: Class:

ADVANCED AGED CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,200/8,500 Initial License: 03/30/2009

Type: Class:

WEST ALLIS CASTLE (0011969) 1234 S 112TH ST WEST ALLIS WI 53214 (414) 607-3776 KRISTOPHER KIEFER County: MILWAUKEE

CASTLE HOME CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,618/4,400 Initial License: 05/30/2007

Type: Class:

WEST PARK PLACE SENIOR LIVING COMMUNITY (00133 EMERITUS CORP DBA EMERITUS CORP OF WA (206) 298-2909 7400 W GREENFIELD AVE DAWN WILLERT WEST ALLIS WI 53214 7400 W GREENFIELD AVE (414) 476-3900 DAWN WILLERT WEST ALLIS WI 53214 County: MILWAUKEE WHITE BIRCH TERRACE (310653) 8500 N GREENVALE RD BAYSIDE WI 53217 (414) 247-1771 KATHRYN ZIMMERMAN County: MILWAUKEE WHITES RESIDENTIAL TREATMENT INC (310659) 2811 W NORTH AVE MILWAUKEE WI 53208 (414) 372-3713 LANELL WHITE County: MILWAUKEE WILLOWGLEN ACADEMY HOWARD HOUSE (310672) 3959 3961 S 51ST ST MILWAUKEE WI 53220 (414) 321-9447 SARA SANDEE County: MILWAUKEE WINGS (310194) 2303 W GALENA ST MILWAUKEE WI 53205 (414) 342-4621 HELEN JOHNSON LEMON County: MILWAUKEE WISCONSIN LUTHERAN LIVING CENTER (310630) 9035 N 97TH ST MILWAUKEE WI 53224 (414) 365-0545 AMY TAGLIENTI County: MILWAUKEE WOODALE (0011984) 4103 W WOODALE AVE BROWN DEER WI 53209 (414) 302-0902 RICHARD HINTZ County: MILWAUKEE ATHENA SPS LLC WHITE BIRCH TERRACE (414) 247-1771 PATRICIA WESTPHAL 8500 N GREENVALE RD BAYSIDE WI 53217 WHITES RESIDENTIAL TREATMENT FACILITY I (414) 536-7098 LANELL WHITE 6400 W CAPITOL STE 212 MILWAUKEE WI 53216 PHOENIX CARE SYSTEMS INC (414) 225-4460 LAKELVIN HILL 5151 W SILVER SPRING DR MILWAUKEE WI 53218-3300 WISCONSIN COMMUNITY SERVICES INC (414) 290-0400 JOSEPH SPOLOWICZ 3732 W WISCONSIN AVE SUITE 200 MILWAUKEE WI 53208 WISCONSIN LUTHERAN CHILD & FAM SER INC (262) 345-5530 AMY TAGLIENTI 9035 N 97TH ST MILWAUKEE WI 53224 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094

CBRF CS Gender - Capacity: M/F - 110 Low/High rate: 1,995/4,000 Initial License: 08/05/2010

Type: Class:

CBRF ANA Gender - Capacity: M/F - 8 Low/High rate: 3,470/3,800 Initial License: 01/14/1998

Type: Class:

CBRF AA Gender - Capacity: M - 14 Low/High rate: 2,250/2,550 Initial License: 01/05/1998

Type: Class:

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 4,504/4,504 Initial License: 05/01/1992

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: F - 13 Low/High rate: 0/2,770 Initial License: 06/28/1994

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 3,000/4,260 Initial License: 08/01/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,067/4,067 Initial License: 08/20/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 83

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,200/3,400 Initial License: 12/21/2005

Type: Class:

AGAPE ACRES LLC (0011150) 3737 BLUEBERRY RD WARRENS WI 54666 (608) 378-4054 TAMMY EWERT County: MONROE BRIDGE PATH (0013540) 503 S. WATER STREET SPARTA WI 54656 (608) 269-3168 CHRISTINE NORDBERG County: MONROE Association Approval: Leading Age CLOSE TO HOME INC (510383) 1206 MARK AVE TOMAH WI 54660 (608) 374-5300 ROBERTA DIETZMAN County: MONROE CRANBERRY COURT I LLC (0010457) 1031 HEELER AVE TOMAH WI 54660 (608) 372-5070 KRISTA WITT County: MONROE CRANBERRY COURT LLC BLDG 2 (0010577) 1025 HEELER AVE TOMAH WI 54660 (608) 372-5070 KRISTA WITT County: MONROE GREENFIELD HOUSE (THE) (0009602) 21444 FLATIRON AVENUE TOMAH WI 54660 (608) 372-7335 MELISSA SHARP County: MONROE LIBERTY VILLAGE LLC (0013967) 200 LIBERTY PLACE TOMAH WI 54660 (608) 374-5005 KRISTA WITT County: MONROE LITTLE FALLS CBRF (510173) 4039 CTY HWY I SPARTA WI 54656 (608) 272-3238 JAMES HEMSTOCK County: MONROE MEADOWS (THE) (0013299) 14345 CTY HWY B SPARTA WI 54656 (608) 269-8839 LINDA ANDERSON County: MONROE REM WALL STREET (0014512) 904 WALL STREET CASHTON WI 54619 (608) 654-5731 SHELLEY HANSEN-BLAKE County: MONROE SUNSET RIDGE ESTATES (510290) 20035 JUNCO RD TOMAH WI 54660 (608) 372-9670 LEANNE MOORE-ALLEN County: MONROE TIME FOR EASE (0010982) 1848 W RIVER SPARTA WI 54656 (608) 269-8532 SUSAN ZILLMER County: MONROE

TAMMY M EWERT (715) 284-1177 TAMMY EWERT 3737 BLUEBERRY RD WARRENS WI 54666 MORROW MEMORIAL HOME FOR THE AGED I (608) 269-3168 MICHAEL BONELLO 331 S WATER ST SPARTA WI 54656 CLOSE TO HOME INC (608) 372-2696 ROBERTA DIETZMAN 1206 MARK AVE TOMAH WI 54660 CRANBERRY COURT LLC (608) 372-5070 KRISTA WITT 1031 HEELER AVE TOMAH WI 54660 CRANBERRY COURT LLC (608) 372-5070 KRISTA WITT 1031 HEELER AVE TOMAH WI 54660 GREENFIELD HOUSE INC (THE) (608) 372-7331 MELISSA SHARP 21444 FLATIRON AVENUE TOMAH WI 54660 LIBERTY VILLAGE LLC (608) 498-2424 KRISTA WITT 200 LIBERTY PLACE TOMAH WI 54660 (608) 272-3238 JAMES HEMSTOCK 4039 CTY HWY I SPARTA WI 54656 MONROE COUNTY DHS (608) 269-8801 LINDA ANDERSON 14345 CTY HWY B SPARTA WI 54656 REM WISCONSIN INC SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 (608) 372-9670 LEANNE MOORE-ALLEN 20035 JUNCO RD TOMAH WI 54660 SUSAN ZILLMER (608) 269-8532 SUSAN ZILLMER 1848 W RIVER RD SPARTA WI 54656

Gender - Capacity:

CBRF CNA M/F - 28 Low/High rate: 3,950/4,250 Initial License: 01/25/2011

Type: Class: Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,542/2,904 Initial License: 02/23/1998 CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 1,700/3,000 Initial License: 01/01/2004

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 1,700/3,000 Initial License: 04/16/2004

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 14 Low/High rate: 1,620/2,500 Initial License: 03/30/2002

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 11 Low/High rate: 2,990/4,839 Initial License: 12/01/2011 CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 1,150/3,100 Initial License: 09/13/1984

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,400/2,880 Initial License: 09/13/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6

Type: Class: Low/High rate:

Initial License:

Type: Class:

02/20/2013

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,479/1,900 Initial License: 12/13/1994 CBRF CNA Gender - Capacity: F - 15 Low/High rate: 2,300/2,500 Initial License: 06/01/2005

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 84

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M - 8 Low/High rate: 770/990 Initial License: 01/04/1990

Type: Class:

TROWBRIDGE PERSONAL CARE RESIDENCE (510046) 110 E COUNCIL ST TOMAH WI 54660 (608) 372-4388 SHELLY TROWBRIDGE County: MONROE COUNTRY HOUSE (0009298) 229 VAN DYKE STREET OCONTO WI 54153 (920) 834-4122 DEBRA TEGGE County: OCONTO

SHELLY TROWBRIDGE (608) 372-4388 SHELLY TROWBRIDGE 110 E COUNCIL ST TOMAH WI 54660 COUNTRY HEALTHCARE INC (920) 662-7535 DEBRA TEGGE PO BOX 190 SUAMICO WI 54173

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 1,850/2,950 Initial License: 03/08/2001

Type: Class:

KING STREET HOUSE (0009946) 106 KING STREET OCONTO FALLS WI 54154 (920) 846-3287 LAURI GEURTS County: OCONTO LAKEWOOD ASSISTED LIVING LLC (0013023) 17185 FLYNN LN LAKEWOOD WI 54138 (715) 276-1680 REBECCA MARKS County: OCONTO SUN VALLEY HOMES II OCONTO 2 (0013969) 427 PECOR ST OCONTO WI 54153 (920) 834-6257 PENNI FRANK County: OCONTO SUPERIOR HOUSE (0009945) 1204 SUPERIOR AVENUE OCONTO WI 54153 (920) 834-2292 LAURI GEURTS County: OCONTO COMMUNITY HOUSE (610105) 520 SOUTH EASTERN AVENUE RHINELANDER WI 54501 (715) 365-7001 JEAN NORTON County: ONEIDA COUNTRY TERRACE MINOCQUA I (0014126) 8726 PACKING PLANT RD MINOCQUA WI 54548 (715) 356-9294 JIM IGNARSKI County: ONEIDA COUNTRY TERRACE MINOCQUA II (0014124) 8730 PACKING PLANT RD MINOCQUA WI 54548 (715) 356-5171 JIM IGNARSKI County: ONEIDA COUNTRY TERRACE MINOCQUA WEST (0014127) 8424 GRANT RD MINOCQUA WI 54548 (715) 356-4638 JIM IGNARSKI County: ONEIDA COUNTRY TERRACE OF WI INC #26 (0014050) 533 E TIMBER DRIVE RHINELANDER WI 54501 (715) 365-3324 JASON LINDEMANN County: ONEIDA

VISIONS OF NEW LLC (920) 834-7770 JACKIE WITT PO BOX 966 OCONTO FALLS WI 54154 LAKEWOOD ASSISTED LIVING LLC (920) 371-2372 REBECCA MARKS 17185 FLYNN LN LAKEWOOD WI 54138 SUN VALLEY HOMES II LLC (920) 370-2371 PENNI L FRANK 875 UNIVERSITY DR MARINETTE WI 54143 VISIONS OF NEW LLC (920) 834-7770 DANIEL SCHROEDER PO BOX 966 OCONTO FALLS WI 54154 COMMUNITY MENTAL HEALTH SRVS INC (715) 365-7000 BEVERLY SCHOENENBERGER PO BOX 895 RHINELANDER WI 54501 COUNTRY TERRACE OF WI INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 COUNTRY TERRACE OF WI INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 COUNTRY TERRACE OF WI INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,400/5,400 Initial License: 02/01/2003

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,900/4,500 Initial License: 11/30/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,000/3,600 Initial License: 01/11/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,357/6,357 Initial License: 02/01/2003

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,270/3,320 Initial License: 09/27/1988

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,500 Initial License: 04/05/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,500 Initial License: 04/05/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,500 Initial License: 04/05/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,500 Initial License: 02/23/2012

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 85

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,250/4,100 Initial License: 04/05/2012

Type: Class:

COUNTRY TERRACE RHINELANDER II (0014128) 1450 W PHILLIPS ST RHINELANDER WI 54501 (715) 362-0333 JAMES IGNARSKI County: ONEIDA CUMBERLAND HEIGHTS (610219) 251 WESTHILL DRIVE RHINELANDER WI 54501 (715) 365-6789 MAUREEN OMELIA County: ONEIDA HERITAGE HOUSE (0008500) 25 EAST FREDRICK STREET RHINELANDER WI 54501 (715) 369-1407 ELIZABETH MEYER County: ONEIDA

COUNTRY TERRACE OF WI INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 PETERSEN COMMUNITY SERVICES MGMT LLC (715) 365-6789 TERREL FRIESE 5943 HWY K RHINELANDER WI 54501 FAMILY MATTERS INC (715) 369-0718 ELIZABETH MEYER PO BOX 304 RHINELANDER WI 54501

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,131/4,073 Initial License: 10/01/1993

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,500 Initial License: 07/26/1999

Type: Class:

MILESTONE MEMORY CARE (0012216) 4686 NORTH SHORE DRIVE RHINELANDER WI 54501 (715) 361-1111 SHARON HOLZ County: ONEIDA MILESTONE SENIOR LIVING MEMORY CARE (0014447) 750 ELM ST WOODRUFF WI 54568 (715) 439-4016 CINDY ROBINSON County: ONEIDA OPTIONS COUNSELING SERVICES LLC (0013977) 1991 WINNEBAGO DR RHINELANDER WI 54501 (715) 362-5745 STACY WEBB County: ONEIDA OUR HOME LAKE TOMAHAWK (0010106) 6416 FLICKER ROAD LAKE TOMAHAWK WI 54539 (715) 277-2010 PATRICIA KOENIG County: ONEIDA AGAPE 2 SILVER SPUR (410537) 15 SILVER SPUR APPLETON WI 54915 (920) 731-7010 CODY VAN HOUT County: OUTAGAMIE AGAPE 3 12TH ST (410039) 412 E 12TH ST KAUKAUNA WI 54130 (920) 766-9776 DAN SCHUCHART County: OUTAGAMIE AGAPE 4 GREENFIELD (410044) 343 E GREENFIELD ST APPLETON WI 54911 (920) 733-4891 PHIL HARTZHEIM County: OUTAGAMIE AGAPE 6 TILLMAN ST (410130) 3013 W TILLMAN ST APPLETON WI 54914 (920) 738-7145 JODI BLUME County: OUTAGAMIE

MILESTONE SENIOR LIVING LLC (608) 819-2200 JULIE HEIL 1574 W BROADWAY STE 200 MADISON WI 53713 MILESTONE SENIOR LIVING LLC (608) 819-2200 JULIE HEIL 1574 W BROADWAY STE 200 MADISON WI 53713 OPTIONS COUNSELING SERVICES LLC (715) 356-5377 STACY WEBB P O BOX 27 MINOCQUA WI 54548-0027 K CARE INC (715) 356-2911 PATRICIA KOENIG 12440 WARPATH LANE MINOCQUA WI 54548 AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661 AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661 AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661 AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/3,750 Initial License: 02/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PREGNANT WOMEN/COUNSELLING PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,600/3,675 Initial License: 01/21/2013

Type: Class:

CBRF AA Gender - Capacity: M/F - 35 Low/High rate: 3,258/6,120 Initial License: 01/01/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,510/4,050 Initial License: 06/23/2003

Type: Class:

CBRF AA Gender - Capacity: F - 8 Low/High rate: 4,202/4,202 Initial License: 01/01/1998

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 6,227/6,460 Initial License: 11/01/1986

Type: Class:

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 4,099/4,099 Initial License: 01/24/1988

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M - 6 Low/High rate: 5,008/7,738 Initial License: 05/01/1987

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 86

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,935/5,935 Initial License: 11/20/1989

Type: Class:

AGAPE 7 FIELDCREST (410189) 3003 FIELDCREST KAUKAUNA WI 54130 (920) 766-0516 SCOTT JOHNSON County: OUTAGAMIE AGAPE 8 CHEROKEE ST (410260) 2237 W CHEROKEE ST APPLETON WI 54914 (920) 832-8198 JODI BLUME County: OUTAGAMIE AGAPE 9 KINGFISHER (410380) N500 KINGFISHER CT APPLETON WI 54915 (920) 687-0522 JENNY RICE County: OUTAGAMIE AMERICAN GRAND ASSISTED LIVING SUITES (0012817) 795 TARRAGON DR KAUKAUNA WI 54130 (920) 759-0690 MICHELLE HUFF County: OUTAGAMIE

AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661 AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661 AGAPE OF APPLETON INC (920) 734-9871 DAN WITT 7 TRI-PARK WAY APPLETON WI 54914-1661 JEFF ZIOLKOWSKI (920) 707-3091 JEFF ZIOLKOWSKI 130 KUETTEL CT NEENAH WI 54956

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 6 Low/High rate: 5,022/5,022 Initial License: 06/14/1991

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,510/5,510 Initial License: 09/01/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 2,850/7,616 Initial License: 06/23/2009

Type: Class:

AMERICAN GRAND ASST LVG SUITE AT COBBLESTONE ( AMERICAN GRAND ASSISTED LIVING SUITES (920) 707-3091 793 TARRAGON DR JEFF ZIOLKOWSKI KAUKAUNA WI 54130 130 KUETTEL CT (920) 759-0741 MICHELLE HUFF NEENAH WI 54956 County: OUTAGAMIE APPLE VALLEY (0009551) 2214 RUSSET CT APPLETON WI 54914 (920) 993-9678 GLORIA SIMON-KUZMA County: OUTAGAMIE AQUA VIEW (410266) BOX 400 W9449 GIVENS RD HORTONVILLE WI 54944 (920) 779-3902 GLORIA SIMON-KUZMA County: OUTAGAMIE BIRCH WAY (0013858) 607 E BRONSON RD SEYMOUR WI 54165 (920) 833-6856 DEBORAH CAPTAIN County: OUTAGAMIE CARE PARTNERS LITTLE CHUTE (0009052) 425 MOASIS DR LITTLE CHUTE WI 54140 (920) 788-7033 LINDA PRICE County: OUTAGAMIE CAROLINA MANOR (0011930) 3201 W 1ST AVENUE APPLETON WI 54914 (920) 738-0118 SHELLE TEGEN County: OUTAGAMIE CASA CLARE A DIVISION OF MOORING PROGRAM INC (0 201 S GLENRIDGE CT APPLETON WI 54914 (920) 731-3981 JAMES LOEHNIS County: OUTAGAMIE CLOVERDALE (0014320) 1825 CLOVERDALE DR APPLETON WI 54914 (920) 609-2784 SHERRY RAMEKER County: OUTAGAMIE BROTOLOC HEALTH CARE SYSTEMS INC DBA B (715) 832-5085 GLORIA SIMON-KUZMA PO BOX 400 HORTONVILLE WI 54944 BROTOLOC HEALTH CARE SYSTEMS INC DBA B (715) 832-5085 GLORIA SIMON-KUZMA PO BOX 400 HORTONVILLE WI 54944 GOOD SHEPHERD SERVICES (920) 833-6856 DEBORAH CAPTAIN 607 E BRONSON RD SEYMOUR WI 54165 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 CAROLINA MANOR ASSISTED LIVING APPLETO (312) 357-1601 BRENT HOLMAN-GOMEZ 125 S WACKER DRIVE STE 1800 CHICAGO IL 60606 MOORING PROGRAMS INC (920) 739-3235 JAMES LOEHNIS 607 W SEVETH ST APPLETON WI 54911 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 3,475/5,700 Initial License: 07/02/2012

Type: Class:

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 5,673/5,673 Initial License: 04/24/2002

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 6,161/6,161 Initial License: 07/01/1991

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,100/4,300 Initial License: 06/27/2012

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 14 Low/High rate: 1,945/3,645 Initial License: 07/01/2000

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 45 Low/High rate: 2,000/2,500 Initial License: 04/30/2007 CBRF AA Gender - Capacity: F - 20 Low/High rate: 3,656/3,656 Initial License: 03/03/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,795/4,795 Initial License: 08/29/2012

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 87

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,600/3,600 Initial License: 11/21/2002

Type: Class:

COUNTRY TERRACE APPLETON (0009664) 749 W PARKWAY BLVD APPLETON WI 54914 (920) 830-3285 VERONICA CASIANO County: OUTAGAMIE DELLVIEW (410293) N2784 HWY 15 HORTONVILLE WI 54944 (920) 779-3905 GLORIA SIMON-KUZMA County: OUTAGAMIE EMERITUS AT FOX RIVER (0013372) 5800 PENNSYLVANIA AVE APPLETON WI 54915 (920) 997-0725 EWA GAWEDA ASHER County: OUTAGAMIE FIELDSTONE HOUSE (0009276) 495 W NYE ST HORTONVILLE WI 54944 (920) 779-0712 GLORIA SIMON-KUZMA County: OUTAGAMIE GRAND HORIZONS (0011338) 5102 N CHERRYVALE AVE APPLETON WI 54913 (920) 997-8090 ZOUA YANG County: OUTAGAMIE GRAND HORIZONS DARBOY (0013832) N9520 SILVER CT APPLETON WI 54915 (920) 832-9290 ZOUA YANG County: OUTAGAMIE

COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903-3006 BROTOLOC HEALTH CARE SYSTEMS INC DBA B (715) 832-5085 GLORIA SIMON-KUZMA PO BOX 400 HORTONVILLE WI 54944 EMERITUS CORP D/B/A EMERITUS CORP OF W (206) 298-2909 EWA GAWEDA ASHER 5800 PENNSYLVANIA AVE APPLETON WI 54915 BROTOLOC HEALTH CARE SYSTEMS INC DBA B (715) 832-5085 GLORIA SIMON-KUZMA PO BOX 400 HORTONVILLE WI 54944-0400 GRAND HORIZONS LLC (920) 997-8090 ZOUA YANG 5102 N CHERRYVALE AVE APPLETON WI 54913 ZOUA L YANG (920) 205-3861 ZOUA YANG 828 E LINDBERGH ST APPLETON WI 54911

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 6,161/6,161 Initial License: 03/01/1992

Type: Class:

CBRF CNA Gender - Capacity: M/F - 95 Low/High rate: 3,082/5,578 Initial License: 08/05/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 5,719/5,719 Initial License: 05/22/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,800/4,500 Initial License: 04/06/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,000/6,500 Initial License: 10/05/2011

Type: Class:

GRAND HORIZONS II (0011963) 5118 N CHERRYVALE AVENUE APPLETON WI 54913 (920) 997-8122 MICHELE PACKETT County: OUTAGAMIE GRAND HORIZONS III (0012690) 5117 N CHERRYVALE AVENUE APPLETON WI 54913 (920) 735-6166 ZOUA YANG County: OUTAGAMIE GRAND HORIZONS KIMBERLY I (0013831) 820 SCHELFHOUT LN KIMBERLY WI 54136 (920) 687-9330 TRACIE H HANG County: OUTAGAMIE GRAND HORIZONS KIMBERLY II (0013878) 816 SCHELFHOUT LN KIMBERLY WI 54136 (920) 809-2334 TRACIE H HANG County: OUTAGAMIE GRAND HORIZONS WEST (0012699) 140 S MAYFLOWER DRIVE GRAND CHUTE WI 54914 (920) 991-9070 ZOUA YANG County: OUTAGAMIE

GRAND HORIZONS (920) 997-8090 ZOUA YANG 5102 N CHERRYVALE AVENUE APPLETON WI 54913 GRAND HORIZONS (920) 997-9080 ZOUA YANG 5102 N CHERRYVALE AVENUE APPLETON WI 54913 TRACIE HANG (920) 809-2334 TRACIE HANG 820 SCHELFHOUT LN KIMBERLY WI 54136 TRACIE HANG (920) 809-2334 TRACIE HANG 816 SCHELFHOUT LN KIMBERLY WI 54136 GRAND HORIZONS WEST (920) 991-9070 ZOUA YANG 5117 N CHERRYVALE AVENUE APPLETON WI 54913

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/4,900 Initial License: 07/03/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/4,900 Initial License: 02/01/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 4,000/5,000 Initial License: 08/22/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 4,000/5,000 Initial License: 10/12/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/4,900 Initial License: 02/01/2009

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 88

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 5,511/6,335 Initial License: 10/27/2005

Type: Class:

HEARTWOOD HOMES SENIOR LIVING INC III (0011054) 1407 N MASON ST APPLETON WI 54914 (920) 955-3500 JASON SCHMITZ County: OUTAGAMIE HEARTWOOD HOMES SENIOR LIVING INC IV (0012559) 1413 N MASON STREET APPLETON WI 54914 (920) 955-3800 JASON SCHMITZ County: OUTAGAMIE KIMBERLY PLACE (0010891) 314 W KIMBERLY AVE KIMBERLY WI 54136 (920) 687-1198 KIERSTEN KARLSEN County: OUTAGAMIE KINDREDHEARTS KAUKAUNA (0009721) 548 FRANCES ST KAUKAUNA WI 54130 (920) 766-4455 ERIN SWEENEY County: OUTAGAMIE KINDREDHEARTS OF GREENVILLE (0013792) W7098 BUTTERCUP CT GREENVILLE WI 54942 (920) 757-0996 CINDY GILLIS County: OUTAGAMIE KLISTER HOUSE (410040) 408 N LAWE ST APPLETON WI 54911 (920) 733-5580 STEVE HINTON County: OUTAGAMIE LIVING TREE ESTATES LLC (0010721) N1916 GREENVILLE DRIVE GREENVILLE WI 54942 (920) 882-5045 JACQUELINE MARTIN County: OUTAGAMIE LSS EASTWOOD CRISIS FACILITY (0010046) 430 S KENSINGTON DR APPLETON WI 54915 (920) 830-3376 LISA SEVERSON County: OUTAGAMIE LSS GRANDSTONE GROUP HOME (0010462) 1308 N LEONA ST APPLETON WI 54911 (920) 730-1028 LISA SEVERSON County: OUTAGAMIE MATTHEWS OF APPLETON I (0014159) W2629 BARNEY CT APPLETON WI 54915 (920) 991-2482 EILEEN ENGLISH County: OUTAGAMIE

HEARTWOOD HOMES SENIOR LIVING INC (920) 419-2490 JASON SCHMITZ 1531 ELK TRAIL CT NEENAH WI 54956 HEARTWOOD HOMES SENIOR LIVING INC (920) 419-2490 JASON SCHMITZ 1531 ELK TRAIL CT NEENAH WI 54956 PRODUCTIVE LIVING SYSTEMS INC (920) 738-5393 KIERSTEN KARLSEN 300 N WOODS EDGE DR STE 103 APPLETON WI 54914 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 ERIN SWEENEY 548 FRANCES ST KAUKAUNA WI 54130 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 DEB ELLIS 5976 EXECUTIVE DR MADISON WI 53719 VILLA PHOENIX INC (920) 731-1316 STEVE HINTON PO BOX 303 APPLETON WI 54912 LIVING TREE ESTATES LLC (920) 882-5045 JACQUELINE MARTIN N1916 GREENVILLE DR GREENVILLE WI 54942 LUTHERAN SOC SERV OF WI & UPPER MI INC (920) 730-1337 PAULA UPP 3003A N RICHMOND ST APPLETON WI 54911 LUTHERAN SOC SERV OF WI & UPPER MI INC (920) 730-1337 TED HAKALA 3003-A N RICHMOND ST APPLETON WI 54911 MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,400/5,750 Initial License: 11/03/2008

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 5,566/5,718 Initial License: 04/27/2005

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,740/2,905 Initial License: 10/02/2002 CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,400/2,800 Initial License: 01/27/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 5 Low/High rate: 3,540/3,882 Initial License: 12/01/1983

Type: Class:

CBRF CNA Gender - Capacity: M/F - 47 Low/High rate: 3,345/5,750 Initial License: 01/25/2005

Type: Class:

CBRF ANA Gender - Capacity: M/F - 8 Low/High rate: 4,190/4,190 Initial License: 04/01/2003

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,782/5,782 Initial License: 03/11/2004

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,270/4,185 Initial License: 06/15/2012

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 89

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,270/4,185 Initial License: 06/15/2012

Type: Class:

MATTHEWS OF APPLETON II (0014158) W2613 BARNEY CT APPLETON WI 54915 (920) 991-2482 EILEEN ENGLISH County: OUTAGAMIE

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

MOORING PROGRAMS INC (410041) 607 W SEVENTH ST APPLETON WI 54911 (920) 739-3235 JAMES LOEHNIS County: OUTAGAMIE PNUMA 1 (410357) W7066 WINNEGAMIE DR APPLETON WI 54914 (920) 832-4090 STEFFIE DANKE County: OUTAGAMIE PNUMA 2 (410381) 233 S LYNNDALE DR APPLETON WI 54914 (920) 734-3092 JULIE GUTCHE County: OUTAGAMIE PROVINCE TERRACE VILLAS LONG CT LLC (0012777) 5216 LONG CT APPLETON WI 54914 (920) 257-2573 ROXANNE REEVES County: OUTAGAMIE

MOORING PROGRAMS INC (920) 739-3235 JAMES LOEHNIS 607 W SEVENTH ST APPLETON WI 54911 PNUMA HEALTH CARE INC (920) 867-4969 JEFFREY CHAUDOIR N3856 LOSS RD WEYAUWEGA WI 54983 PNUMA HEALTH CARE INC (920) 867-4969 JEFFREY CHAUDOIR N3856 LOSS RD WEYAUWEGA WI 54983 ROXANNE REEVES (920) 257-2573 ROXANNE REEVES 5216 LONG CT APPLETON WI 54914

CBRF AA Gender - Capacity: M - 19 Low/High rate: 2,432/2,478 Initial License: 11/01/1980

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 5,232/5,232 Initial License: 11/22/1993

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY CORRECTIONAL CLIENTS

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 4,167/4,167 Initial License: 07/27/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,800/4,500 Initial License: 10/28/2009

Type: Class:

ROGERS (0014325) 1719 ROGERS ST APPLETON WI 54914 (920) 609-3836 JESSICA KETTNER County: OUTAGAMIE RUSSET (0014323) 2210 RUSSET CT APPLETON WI 54911 (920) 370-5806 AMY WILLIAMS County: OUTAGAMIE RYAN COMMUNITY INC (410043) 1338 W PROSPECT AVE APPLETON WI 54914-5069 (920) 731-3768 JOSEPH WILZ County: OUTAGAMIE SHEPHERD'S INN (0013175) 621 W FACTORY ST SEYMOUR WI 54165 (920) 833-6856 DEBORAH CAPTAIN County: OUTAGAMIE Association Approval: Leading Age SYLVAN VIEW (410275) W9405 GIVENS RD HORTONVILLE WI 54944 (920) 779-3910 GLORIA SIMON-KUZMA County: OUTAGAMIE

CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 RYAN COMMUNITY INC (920) 731-3768 JOSEPH WILZ 1338 W PROSPECT AVE APPLETON WI 54914-5069 GOOD SHEPHERDS SERVICES LTD (920) 833-6856 DEBORAH CAPTAIN 607 E BRONSON RD SEYMOUR WI 54165

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 6,195/6,195 Initial License: 08/30/2012

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 7 Low/High rate: 4,704/4,704 Initial License: 08/29/2012

Type: Class:

Gender - Capacity:

CBRF AA M - 16 Low/High rate: 0/0 Initial License: 06/01/1980

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,777/4,250 Initial License: 01/26/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY

BROTOLOC HEALTH CARE SYSTEMS INC DBA B (715) 832-5085 GLORIA SIMON-KUZMA PO BOX 400 HORTONVILLE WI 54944

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 6,154/6,154 Initial License: 08/01/1991

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 90

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 20 Low/High rate: 2,900/3,600 Initial License: 12/08/1989

Type: Class:

TRI MANOR SOUTH (410200) 1312 S MONROE ST APPLETON WI 54915 (920) 749-0700 DAWN JENSEN County: OUTAGAMIE VAN DYKE (0014137) 1811 S VAN DYKE RD APPLETON WI 54914 NANCY COLLIER County: OUTAGAMIE VILLA HOPE (410105) 613 N DIVISION ST APPLETON WI 54911 (920) 739-5337 BILL DRISCOLL County: OUTAGAMIE VILLA PHOENIX (410046) 418 N LAWE ST APPLETON WI 54912 (920) 731-1316 STEVE HINTON County: OUTAGAMIE ANITAS GARDENS (0011800) 117 E VAN BUREN PORT WASHINGTON WI 53074 (262) 268-9780 KATHLEEN MAHONEY County: OZAUKEE BELGIUM GARDENS (0012459) 432 HERITAGE ST BELGIUM WI 53004 (262) 285-3660 MARY M READ County: OZAUKEE CEDAR GARDENS (0011384) W56 N225 MCKINLEY BLVD CEDARBURG WI 53012 (262) 376-7700 JERI STROIMAN County: OZAUKEE CNC FAMILY LIVING LLC DBA DEKORA SPRINGS (00136 214 W DEKORA ST SAUKVILLE WI 53080 (262) 268-8234 CRAIG NICHELSON County: OZAUKEE CORNERSTONE GROUP HOME (0012525) 1521 W 2ND AVE PORT WASHINGTON WI 53074 (262) 284-9656 MELANIE CLAUSING County: OZAUKEE ELLENS HOME PORT WASHINGTON (0012363) 1800 GRANITE RD PORT WASHINGTON WI 53074 (262) 268-9555 BONNIE SANFELIPPO County: OZAUKEE GOOD HOPE MANOR MILWAUKEE PORT OF HOPE (001 226 N SPRING ST PORT WASHINGTON WI 53074 (262) 268-0301 BRADLY ZWICKER County: OZAUKEE

TRI MANOR LTD (920) 745-2370 RICHARD SCHULZ 504 WOODSIDE AVE RIPON WI 54971 CLARITY CARE INC (920) 236-6560 SANDRA DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 VILLA HOPE INC (920) 739-5337 BILL DRISCOLL PO BOX 1733 APPLETON WI 54913 VILLA PHOENIX INC (920) 731-1316 STEVE HINTON PO BOX 303 APPLETON WI 54912 BRIKAT ENTERPRISES LLC (262) 268-0264 KATHLEEN MAHONEY 635 W PIERRE LN PORT WASHINGTON WI 53074-1531 SANDVIEW LLC (262) 873-0034 MARY READ 1698 AQUA VIEW CT CEDARBURG WI 53012-9146 ALC OPERATING LLC (262) 257-8888 MARY ZAK KOWALCZYK W140 N8981 LILLY RD MENOMONEE FALLS WI 53051 CNC FAMILY LIVING LLC (920) 994-9268 CRAIG NICHELSON 214 W DEKORA ST SAUKVILLE WI 53080 INDIVIDUAL GROWTH SERVICES INC (262) 284-9656 MELANIE CLAUSING 117 N MILWAUKEE ST PORT WASHINGTON WI 53074 ELLENS HOME OF PORT WASHINGTON LLC (414) 531-2672 BONNIE SANFELIPPO 1800 GRANITE RD PORT WASHINGTON WI 53074 WITZLIB (414) 708-4802 LINDA WITZLIB 226 N SPRING ST PORT WASHINGTON WI 53074

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,879/4,879 Initial License: 08/08/2012

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING

CBRF AS Gender - Capacity: M - 15 Low/High rate: 1,700/2,294 Initial License: 10/22/1981

Type: Class:

CBRF AA Gender - Capacity: M - 17 Low/High rate: 2,737/2,798 Initial License: 08/12/1980

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 19 Low/High rate: 3,600/4,600 Initial License: 03/13/2007

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/5,000 Initial License: 08/01/2008 CBRF CNA Gender - Capacity: M/F - 65 Low/High rate: 3,420/4,170 Initial License: 04/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 3,450/3,600 Initial License: 06/01/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,106/5,019 Initial License: 09/23/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 44 Low/High rate: 4,000/5,500 Initial License: 09/09/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 7,340/7,790 Initial License: 04/30/2004

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 91

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 12 Low/High rate: 3,262/5,040 Initial License: 07/01/1988

Type: Class:

HAMBURG HOME (310406) 1951 FIRST AVE GRAFTON WI 53024 (262) 375-1325 DEBRA MCDANIEL County: OZAUKEE HARBOR CLUB (THE) (310408) 425 W WALTERS ST PORT WASHINGTON WI 53074 (262) 268-1800 CATHERINE TORCIVIA County: OZAUKEE HARRISON HOME (310409) W72 N675 HARRISON AVE CEDARBURG WI 53012 (262) 375-0661 DEBRA MCDANIEL County: OZAUKEE HIAWATHA HOUSE (0014406) 4415 W HIAWATHA DR MEQUON WI 53092 (262) 242-3711 SCOTT WILDER County: OZAUKEE HIGHLAND (0014294) 3987 HIGHLAND DR PORT WASHINGTON WI 53074 (262) 284-8896 MELANIE CLAUSING County: OZAUKEE LCS WESTMINSTER NEWCASTLE LLC (0014331) 12600 N PORT WASHINGTON RD MEQUON WI 53092 (262) 387-8860 GEORGIA DZWINEL County: OZAUKEE LUTHER MANOR AT RIVER OAKS (0009128) 11340 N CEDARBURG RD MEQUON WI 53092 (262) 242-6660 PAM BUCHOLZ County: OZAUKEE MILAN ESTATES (0013355) 715 MILAN DR SAUKVILLE WI 53080 (262) 284-1601 JULIANA PEREZ County: OZAUKEE NEW PERSPECTIVE MEQUON LLC (0011450) 3111 W MEQUON RD MEQUON WI 53092 (262) 242-1199 KIMBERLY OTTE County: OZAUKEE NORPORT GROUP HOME (310490) 411 E NORPORT DR PORT WASHINGTON WI 53074 (262) 284-6898 MELANIE CLAUSING County: OZAUKEE OAK COURT GROUP HOME (310491) 1265 OAK CT PORT WASHINGTON WI 53074 (262) 284-3702 MELANIE CLAUSING County: OZAUKEE PINEVIEW (0011696) 219 LAWRENCE ST FREDONIA WI 53021 (262) 692-2817 BRADLY ZWICKER County: OZAUKEE

FAMILY TREE RESIDENTIAL FAC INC (262) 375-0661 DEBRA MCDANIEL W63 N124 WASHINGTON AVE CEDARBURG WI 53012 HARBOR CLUB LLC (THE) (262) 268-1800 CATHERINE TORCIVIA 425 W WALTERS ST PORT WASHINGTON WI 53074 FAMILY TREE RESIDENTIAL FAC INC (262) 375-0661 DEBRA MCDANIEL W63 N124 WASHINGTON AVE CEDARBURG WI 53012 SCOTT WILDER (414) 540-6479 SCOTT WILDER 3808 W ELM ST MILWAUKEE WI 53209 INDIVIDUAL GROWTH SERVICES (262) 284-9656 MATTHEW NUERNBERG 117 N MILWAUKEE ST PORT WASHINGTON WI 53074 LCS WESTMINSTER NEWCASTLE LLC (515) 875-4590 GEORGIA DZWINEL 12600 N PORT WASHINGTON RD MEQUON WI 53092 UNITED LUTHERAN PROGRAM FOR THE AGING (414) 464-3880 PAM BUCHOLZ 4545 N 92ND ST WAUWATOSA WI 53225 SAUKVILLE INVESTMENTS LLC (262) 243-9610 STEVE WITKOWSKI 715 MILAN DR SAUKVILLE WI 53080 NEW PERSPECTIVES SENIOR LIVING (952) 746-3630 CARRIE KLUG 3111 W MEQUON RD MEQUON WI 53092 INDIVIDUAL GROWTH SERVICES INC (262) 284-9656 SHAWN MILES 117 N MILWAUKEE ST PORT WASHINGTON WI 53074 INDIVIDUAL GROWTH SERVICES INC (262) 284-9656 SHAWN MILES 117 N MILWAUKEE ST PORT WASHINGTON WI 53074 LINDA WITZLIB (262) 692-2817 LINDA WITZLIB 219 LAWRENCE ST FREDONIA WI 53021

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 70 Low/High rate: 3,275/4,850 Initial License: 03/01/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,715/5,700 Initial License: 03/01/1995

Type: Class:

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 2,200/2,500 Initial License: 11/14/2012

Type: Class:

Gender - Capacity:

CBRF AA M/F - 5 Low/High rate: 4,124/4,124 Initial License: 09/19/2012

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 4,347/5,347 Initial License: 11/01/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 3,729/5,400 Initial License: 10/11/2000

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,250/5,000 Initial License: 08/10/2010 CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,870/4,410 Initial License: 06/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,911/3,911 Initial License: 01/01/1982

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,811/3,348 Initial License: 08/01/1995

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 7,540/7,584 Initial License: 01/31/2007

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 92

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,460/3,770 Initial License: 01/16/2008

Type: Class:

PORT HAVEN (0012186) 334 S GARFIELD ST PORT WASHINGTON WI 53074 (262) 284-3908 CRAIG NICHELSON County: OZAUKEE SARAH CHUDNOW CAMPUS (0010816) 10995 NORTH MARKET ST MEQUON WI 53092 (262) 478-1500 PAUL SCHULTZ County: OZAUKEE Association Approval: Leading Age SERENITY HOMES OF GRAFTON LLC (0012709) 1706 W WASHINGTON ST GRAFTON WI 53024 (262) 377-2250 KATHRYN PETERSON County: OZAUKEE SHAER RESIDENTIAL FACILITY (0010741) 213 W ALTALOMA CR THIENSVILLE WI 53092 (262) 242-7498 MICHAEL YELIN County: OZAUKEE

PORT HAVEN (262) 284-3908 CRAIG NICHELSON 334 S GARFIELD ST PORT WASHINGTON WI 53074 MEQUON JEWISH CAMPUS INC (262) 478-1501 PAUL SCHULTZ 10995 NORTH MARKET ST MEQUON WI 53092 LEWIS M HERRO (262) 377-4501 KATHRYN PETERSON 1706 WASHINGTON GRAFTON WI 53024 COUNTRYVIEW GROUP HOME LLC (262) 243-5515 ZVIA SHAER 2145 W HEMLOCK RD GLENDALE WI 53209

CBRF CNA Gender - Capacity: M/F - 9 Low/High rate: 4,995/4,995 Initial License: 03/24/2005

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 4,500/5,000 Initial License: 02/19/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,300/7,500 Initial License: 10/18/2004

Type: Class:

SILVER SPRINGS (0012125) 11840 N SILVER AVE MEQUON WI 53097 (262) 643-4223 JACQUELYNN C CHIARELLI County: OZAUKEE WASHINGTON HEIGHTS CBRF INC (0009969) 1515 WASHINGTON ST GRAFTON WI 53024 (262) 377-5070 RENEA DATZ County: OZAUKEE WOODLAND VIEW ESTATE (0011745) 348 S MILWAUKEE ST FREDONIA WI 53021 (262) 692-3760 DEBRA RICHARDS County: OZAUKEE

SILVER SPRINGS OF MEQUON INC (262) 643-4223 JACQUELYNN C CHIARELLI 11840 N SILVER AVE MEQUON WI 53097 WASHINGTON HEIGHTS CBRF INC (262) 377-5070 RENEA DATZ 1515 WASHINGTON ST GRAFTON WI 53024 WOODLAND VIEW OF FREDONIA LLC (920) 254-6262 HEATHER STAUTZ 409 FOND DU LAC AVE SHEBOYGAN FALLS WI 53085

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,000/6,955 Initial License: 03/04/2008

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,150/3,800 Initial License: 03/03/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 2,700/3,450 Initial License: 04/11/2007

Type: Class:

LAKEVIEW RESIDENCE (0013844) 1112 SECOND ST PEPIN WI 54759 (715) 442-4811 DALE ANDERSON County: PEPIN CEDAR HOUSE (510278) 145 W SUMMIT AVE ELLSWORTH WI 54011 (715) 273-3171 LADONNA MAHER County: PIERCE COMFORTS OF HOME-RIVER FALLS CBRF (0012426) 2328 AURORA CIRCLE RIVER FALLS WI 54022 (715) 425-1530 JULIE CHOLLET County: PIERCE

HEYDE HEALTH SYSTEM - PEPIN, LLC (715) 726-9094 DALE ANDERSON 1112 SECOND STREET PEPIN WI 54759 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 NANCY STEWART PO BOX 848 ELLSWORTH WI 54011 RIVER FALLS CBRF LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 2,960/4,423 Initial License: 04/01/2012

Type: Class:

CBRF CA Gender - Capacity: M/F - 5 Low/High rate: 4,560/4,560 Initial License: 04/02/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 3,500/4,300 Initial License: 06/23/2008

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 93

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,232/5,232 Initial License: 07/06/2004

Type: Class:

COUNTRYSIDE (0010637) N5335 - 760TH ST ELLSWORTH WI 54011 (715) 273-5060 DEB ROMAN County: PIERCE KINNIC FALLS ALCOHOL DRUG SERVS INC (0008581) 900 SOUTH ORANGE STREET RIVER FALLS WI 54022 (715) 426-5950 JENNIFER BYRON County: PIERCE OUR HOUSE ASSISTED CARE (0013425) 902 S WASSON LANE RIVER FALLS WI 54022 (715) 426-0151 BRITTANI ROTT County: PIERCE PARKSIDE (0009712) 258 N BEULAH ST ELLSWORTH WI 54011 (715) 273-5060 TAMMY LARSON County: PIERCE RIDGEWOOD CBRF (510281) 7211 N HWY 65 RIVER FALLS WI 54022 (715) 425-1183 MARGE DOWNING County: PIERCE SEASONS (THE) (510234) 207 WEST STREET PLUM CITY WI 54761 (715) 647-2169 JANICE GIRARD County: PIERCE SUMMIT VIEW (510279) 278 N BEULAH STREET ELLSWORTH WI 54011 (715) 273-6696 DEBORAH ROMAN County: PIERCE CHRISTIAN COMMUNITY HOME OF OSCEOLA (0013865) 2650 65TH AVENUE OSCEOLA WI 54020 (715) 294-4277 NATALIE HEJNY County: POLK CLEAR LAKE MANOR (510357) 460 2ND AVENUE CLEAR LAKE WI 54005 (715) 263-2399 RONALD WEISS County: POLK COMFORTS OF HOME - FREDERIC (0010757) 105 E OAK ST FREDERIC WI 54837 (715) 327-4394 JANET OLSON County: POLK COMFORTS OF HOME - ST CROIX II (0010569) 341 MCKENNEY ST ST CROIX FALLS WI 54024 (715) 483-1707 JANET OLSON County: POLK COMFORTS OF HOME-ST CROIX FALLS I (0010062) 343 MCKENNEY STREET ST CROIX FALLS WI 54024 (715) 483-1707 JANET OLSON County: POLK

BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 NANCY STEWART BOX 848 ELLSWORTH WI 54011 KINNIC FALLS ALCOHOL DRUG SERVS INC (715) 426-5950 JENNIFER BYRON 902 S ORANGE ST RIVER FALLS WI 54022-2819 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 NANCY STEWART P O BOX 848 ELLSWORTH WI 54011 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 NANCY STEWART PO BOX 848 ELLSWORTH WI 54011 PLUM CITY CARE CENTER INC (715) 647-2401 AMY FETZER 301 CHERRY AVENUE W PLUM CITY WI 54761 BROTOLOC INC DBA BROTOLOC NORTH (715) 832-5085 NANCY STEWART PO BOX 848 ELLSWORTH WI 54011 CHRISTIAN COMMUNITY HOME OF OSCEOLA (715) 381-4210 NATALIE HEJNY 2650 65TH AVENUE OSCEOLA WI 54020 (715) 263-2167 RONALD WEISS BOX 294 CLEAR LAKE WI 54005 FREDERIC COH LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118 ST CROIX FALLS COH LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118 ST CROIX FALLS COH LLC (651) 287-0265 ST CROIX FALLS COH 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118

Gender - Capacity:

CBRF AA M - 44 Low/High rate: 2,106/2,869 Initial License: 09/02/1981

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,300/3,675 Initial License: 09/30/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 4,170/4,170 Initial License: 10/02/2002

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 6,113/6,113 Initial License: 02/15/1995

Type: Class: Type: Class:

CBRF AS Gender - Capacity: M/F - 14 Low/High rate: 2,161/2,161 Initial License: 10/20/1992 CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 5,136/5,136 Initial License: 03/05/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20

Type: Class: Low/High rate:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED

Initial License:

Type: Class:

11/01/2011

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,800/2,300 Initial License: 02/11/1997 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,100/5,000 Initial License: 11/13/2004

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,800/5,000 Initial License: 05/01/2004

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,700/5,000 Initial License: 06/01/2003

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 94

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,800/4,100 Initial License: 10/13/2011

Type: Class:

FREDERIC COMFORTS OF HOME 2 (0013890) 107 EAST OAK STREET FREDERIC WI 54837 (715) 327-4394 JANET OLSON County: POLK LAWSON MANOR (0013979) 625 S. SECOND ST LUCK WI 54853 (715) 472-2164 DANIEL VALENTINE County: POLK Association Approval: Leading Age RIVERBEND (0010999) 475 GOLFVIEW AMERY WI 54001 (715) 268-9949 DENISE OLSON County: POLK SOPHIES MANOR ASSISTED LIVING II INC (0012368) 300 MICHIGAN AVE CENTURIA WI 54824 (715) 640-3330 DARLENE NAHKALA County: POLK AURORA RESIDENTIAL ALTERNATIVES INC #062 (00130 651 N 2ND ST STEVENS POINT WI 54481 (715) 345-2624 HOLLY HAKES County: PORTAGE BROWNS HAZEL INN OF STEVENS POINT (0013184) 716 DIVISION ST STEVENS POINT WI 54481 (715) 544-4794 WINNIE LUKASZEWSKI County: PORTAGE CARE PARTNERS STEVENS POINT #1 (0011953) 3349 BLDG A WHITING AVENUE STEVENS POINT WI 54481 (715) 345-9904 PAULA HUNTER-WILHELM County: PORTAGE CARE PARTNERS STEVENS POINT #2 (0011954) 3349 BLDG B WHITING AVENUE STEVENS POINT WI 54481 (715) 341-1556 PAULA HUNTER-WILHELM County: PORTAGE HARMONY OF STEVENS POINT (0009568) 1800 BLUEBELL LANE STEVENS POINT WI 54481 (715) 344-7902 JULIE MOUW County: PORTAGE Association Approval: WiCAL MAPLE RIDGE OF PLOVER (0012042) 2831 MAPLE DRIVE PLOVER WI 54467 (715) 341-0909 KELLY PLISKA County: PORTAGE MAPLE RIDGE OF PLOVER MEMORY CARE (0012043) 2841 MAPLE DRIVE PLOVER WI 54467 (715) 342-0800 KELLY PLISKA County: PORTAGE

TRADITIONS OF FREDERIC LLC (952) 224-2133 RHONDA SCHILLINGER 720 MAIN ST, SUITE 205 MENDOTA HEIGHTS MN 55118 UNITED PIONEER HOME, INC (715) 472-8475 DANIEL VALENTINE 623 S. SECOND ST LUCK WI 54853 AMERY ASSISTED LIVING LLC (715) 268-9949 DENISE OLSON 475 GOLFVIEW AMERY WI 54001 LISA HOADLEY (763) 444-4771 LISA HOADLEY P O BOX 340 CENTURIA WI 54824 AURORA RESIDENTIAL ALTERNATIVES (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 BROWNS ASSISTED LIVING LLC (715) 652-2338 TERRY HOWARD 6409 COUNTY RD N ARPIN WI 54410 CARE PROPERTIES LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 CARE PROPERTIES LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVENUE 101 MENOMONEE FALLS WI 53051 JESSICA SCHMIDT (715) 498-4949 JESSICA SCHMIDT 2831 MAPLE DRIVE PLOVER WI 54467 JESSICA SCHMIDT (715) 498-4949 JESSICA SCHMIDT 2831 MAPLE DRIVE PLOVER WI 54467

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,300/4,300 Initial License: 02/23/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 11 Low/High rate: 4,019/5,363 Initial License: 09/01/2005

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,400/3,900 Initial License: 05/23/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,551/8,969 Initial License: 12/17/2009

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,011/3,500 Initial License: 02/09/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,702/3,952 Initial License: 07/02/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,702/3,952 Initial License: 07/02/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 52 Low/High rate: 2,141/4,001 Initial License: 07/12/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,920/4,000 Initial License: 09/01/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,920/4,800 Initial License: 09/01/2007

Type: Class:

MINISTRY BEHAVIORAL HLTH/RES TREATMENT CENTER ( MINISTRY BEHAVIORAL HEALTH (715) 344-4611 201 PRENTICE STREET NORTH LAURIE ROBERTS STEVENS POINT WI 54481 209 PRENTICE ST NORTH (715) 345-0711 MICHAEL SLAVIN STEVENS POINT WI 54481 County: PORTAGE

Gender - Capacity:

CBRF AS M/F - 15 Low/High rate: 3,750/9,520 Initial License: 04/01/1986

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 95

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 27 Low/High rate: 2,950/5,500 Initial License: 06/11/2001

Type: Class:

NORTH CREST (0009320) 2225 EAGLE SUMMIT STEVENS POINT WI 54482 (715) 343-1288 KELLY OPIOLA County: PORTAGE NORTH HAVEN (0008672) 2301 EAGLE SUMMIT STEVENS POINT WI 54482 (715) 343-8820 JUDY LIEBE County: PORTAGE NORTH RIDGE (0010600) 2201 EAGLE SUMMIT STEVENS POINT WI 54482 (715) 343-8825 KRISTA MENDYKE County: PORTAGE OAKRIDGE SENIOR LIVING COMMUNITY (0013390) 5625 SANDPIPER DR STEVENS POINT WI 54482 (715) 343-7376 MARCIA MCDONALD County: PORTAGE POINT MANOR (0010796) 1800 SHERMAN AVENUE STEVENS POINT WI 54481-7215 (715) 344-0207 JENNIFER LOWERY County: PORTAGE Association Approval: Leading Age PORTAGE HOUSE (610004) 1019 ARLINGTON PLACE STEVENS POINT WI 54481 (715) 346-1436 ZACHARY BISHOP County: PORTAGE SYLVAN CROSSINGS OF STEVENS POINT (0011469) 100 NORTH GREEN AVENUE STEVENS POINT WI 54481 (715) 345-2304 JULIE SIUDZINSKI County: PORTAGE WELLINGTON PLACE OF WHITING (0012046) 1902 POST ROAD STEVENS POINT WI 54481 (715) 344-9669 AMBER HAFERMAN County: PORTAGE WHISPERING PINES CBRF (0012331) 3380 BRIDLEWOOD DR PLOVER WI 54467 (715) 342-4445 KAREN TRZEBIATOWSKI County: PORTAGE ASPIRUS PLEASANT VIEW-REGENCY HOUSE (0012357) 615 PETERSON AVENUE PHILLIPS WI 54555 (715) 339-6284 MICHELLE HERSHEY County: PRICE PARK PLACE (0013451) 349 FIRST AVE N PARK FALLS WI 54552-1431 (715) 762-3622 JANE NOVITZKE County: PRICE APPLEWOOD COTTAGE (0013462) 7711 BIG BEND RD WATERFORD WI 53185 (262) 210-6189 JAN CAFLISCH County: RACINE

KRISTA MENDYKE (715) 343-8820 KRISTA MENDYKE 2225 EAGLE SUMMIT STEVENS POINT WI 54482 (715) 498-1678 KRISTA MENDYKE 2225 EAGLE SUMMIT STEVENS POINT WI 54482 KRISTA MENDYKE (715) 341-8624 KRISTA MENDYKE 2225 EAGLE SUMMIT STEVENS POINT WI 54482 EMERITUS CORP D/B/A EMERITUS CORP OF W (206) 298-2909 MARCIA MCDONALD 5625 SANDPIPER DR STEVENS POINT WI 54482 TNIOP HOUSING LLC (920) 991-9072 JENNIFER LOWERY 1800 SHERMAN AVENUE STEVENS POINT WI 54481-7215 PORTAGE COUNTY (715) 346-1436 ZACHARY BISHOP 1019 ARLINGTON PLACE STEVENS POINT WI 54481 TOUCHSTONE SENIOR SERVICES LLC (608) 276-3449 DANIEL FLEMING 2960 TRIVERTON PIKE DR STE 202 MADISON WI 53711 WELLINGTON HOMES OF WISCONSIN LLC (703) 868-0503 AMBER HAFERMAN 1902 POST ROAD STEVENS POINT WI 54481 CRYSTAL FOUNTAINS ASSISTED LIVING LLC (715) 348-9100 KAREN TRZEBIATOWSKI 3450 BRIDLEWOOD DR PLOVER WI 54467 ASPIRUS EXTENDED SERVICES INC (715) 847-2116 CARI LOGEMANN 3000 WESTHILL DRIVE STE300 WAUSAU WI 54401 PARK FALLS PARK PLACE LLC (715) 762-3622 JANE NOVITZKE 349 FIRST AVE N PARK FALLS WI 54552-1431 ELDER CARE COTTAGES OF WISCONSIN (262) 210-6189 SHELLY SCHILLING 7711 BIG BEND RD WATERFORD WI 53185

Gender - Capacity:

CBRF CNA M/F - 22 Low/High rate: 2,900/5,500 Initial License: 09/08/1999

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,250/3,750 Initial License: 05/27/2004 CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,200/4,100 Initial License: 08/05/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 29 Low/High rate: 2,600/3,400 Initial License: 12/01/2004

Type: Class:

CBRF AA Gender - Capacity: M - 12 Low/High rate: 27,111/27,111 Initial License: 04/01/1980

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,000/4,300 Initial License: 05/01/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 3,218/5,508 Initial License: 09/07/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 2,700/4,300 Initial License: 03/05/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,780/3,431 Initial License: 04/01/2008

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,553/5,262 Initial License: 07/12/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,000/3,395 Initial License: 10/01/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 96

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 3,000/5,000 Initial License: 05/15/2007

Type: Class:

ARBOR VIEW COMMUNITIES (0011841) 34201 ARBOR LN BURLINGTON WI 53105 (262) 539-2728 LINDA KRAJNAK County: RACINE

SC LIVING LLC (847) 445-6041 LINDA KRAJNAK 34201 ARBOR LN BURLINGTON WI 53105

ARBOR VIEW MEMORY CARE (0013680) 34111 ARBOR LN BURLINGTON WI 53105 (262) 539-2730 LINDA KRAJNAK County: RACINE ARTISAN RACINE (THE) (0014434) 6109 BRAUN RD RACINE WI 53403 (262) 554-6765 MARGARET STAHL County: RACINE EAGLE HOUSE (310369) 807 53RD DR UNION GROVE WI 53182 (262) 835-8370 ANGELA ANDERSEN County: RACINE ELIZABETH RESIDENCE CALEDONIA (0013065) 5737 ERIE ST RACINE WI 53402 (262) 639-6015 RICHARD COURY County: RACINE GENESIS CHATHAM HOUSE (0009385) 1636 CHATHAM ST RACINE WI 53402 (262) 637-2679 PAULINE ORTLOFF County: RACINE GENESIS CROSSROADS (310435) 4107 4109 ST CLAIR ST RACINE WI 53402 (262) 633-3889 PAULINE ORTLOFF County: RACINE GENESIS SPRING PLACE (310621) 1725 1727 SPRING PL RACINE WI 53404 (262) 633-3889 PAULINE ORTLOFF County: RACINE HARMONY OF RACINE (0008670) 8600 CORPORATE DR RACINE WI 53406 (262) 884-8097 SARAH SEARLES County: RACINE Association Approval: WiCAL HIL FOX MEAD GROUP HOME (0009691) 516 FOX MEAD CROSSING WATERFORD WI 53185 (262) 514-3500 LISA GRANDBERRY County: RACINE HIL HILLSIDE (0009760) 373 CHURCH ST BURLINGTON WI 53105 (262) 767-2897 BRAE KITTELSON County: RACINE HIL KENDRICK HOME (0010610) 265 N KENDRICK AVE BURLINGTON WI 53105 (262) 767-7411 LISA GRANDBERRY County: RACINE

SHERRY CZISNY (262) 539-2728 SHERRY CZISNY 34111 ARBOR LANE BURLINGTON WI 53105 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 COMMUNITY CONNECTION LLC (414) 906-1915 ROBERT LIEBERMAN 5225 N IRONWOOD LN STE 116 GLENDALE WI 53217 RICHJON DBA ELIZABETH RESIDENCE CALEDO (414) 540-4141 RICHARD COURY 6340 N GREEN BAY AVE GLENDALE WI 53209 GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST #2210 WEST ALLIS WI 53214 GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST #2210 WEST ALLIS WI 53214 GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST #2210 WEST ALLIS WI 53214 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE STE101 MENOMONEE FALLS WI 53051 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072

Gender - Capacity:

CBRF CNA M/F - 10 Low/High rate: 4,200/5,200 Initial License: 04/27/2011

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,300/5,000 Initial License: 12/01/2012 CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,500/4,500 Initial License: 10/10/1995

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS PREGNANT WOMEN/COUNSELLING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 50 Low/High rate: 4,000/6,000 Initial License: 03/15/2010

Type: Class:

CBRF AA Gender - Capacity: F - 12 Low/High rate: 2,417/2,417 Initial License: 07/27/2001

Type: Class:

CBRF AA Gender - Capacity: F - 9 Low/High rate: 2,705/2,705 Initial License: 10/15/1990

Type: Class:

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,417/2,417 Initial License: 10/01/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 42 Low/High rate: 2,400/4,700 Initial License: 06/28/1999

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 7,521/7,521 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 5,777/5,777 Initial License: 01/01/2002

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 5,928/5,928 Initial License: 08/10/2005

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 97

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 9,034/9,034 Initial License: 06/23/2008

Type: Class:

HIL KENNEDY HOME (0012307) 4305 4307 KENNEDY DR RACINE WI 53404 (262) 456-4279 SHARON JOHNSON County: RACINE HIL WANDA FROGG VILLA/MEADOWHAVEN (0012315) 524 SUMMIT AVE BURLINGTON WI 53105 (262) 767-0239 LISA GRANDBERRY County: RACINE LAKEVIEW REHABILITATION CENTER (310445) 1701 SHARP RD WATERFORD WI 53185 (262) 534-7297 ROBYN RUSHING County: RACINE LONG LAKE HOUSE (0011322) 8208 RACINE AVE WIND LAKE WI 53185 (262) 895-3052 PAULA HEYER County: RACINE

HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 LAKEVIEW NEUROREHAB CTR MIDWEST INC (262) 534-7297 LAURIE RUMPF 1701 SHARP RD WATERFORD WI 53185 AFFINITY HEALTH CARE LLC (262) 895-3052 PAULA HEYER 8208 RACINE AVE WIND LAKE WI 53185

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,506/5,506 Initial License: 06/03/2008

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 5,131/23,573 Initial License: 10/01/1996

Type: Class: Type: Class:

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 4,500/6,000 Initial License: 08/30/2006

MAPLEWOOD COTTAGE (0013527) 7711 BIG BEND RD WATERFORD WI 53185 (262) 210-6189 JAN CAFLISCH County: RACINE

ELDER CARE COTTAGES OF WISCONSIN (262) 210-6189 SHELLY SCHILLING 7711 BIG BEND RD WATERFORD WI 53185

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,000/3,395 Initial License: 10/01/2010

Type: Class:

NEURORESTORATIVE WISCONSIN (0013091) 5310 BUENA PARK RD WATERFORD WI 53185 (262) 534-4864 ANN MEEKS County: RACINE NEW BEGINNINGS GROUP HOMES II (310482) 3509 S GREEN BAY RD RACINE WI 53403 (262) 554-9566 WALTER DAVIS County: RACINE NEW BEGINNINGS GROUP HOMES IV (310600) 6545 LINCOLNSHIRE DR RACINE WI 53403 (262) 552-2955 WALTER DAVIS County: RACINE NEW BEGINNINGS GROUP HOMES V (0009068) 1449 N GREEN BAY RD RACINE WI 53406 (262) 633-9920 WALTER DAVIS County: RACINE NEWMAN MANOR II (0009510) 4604 SPRING ST RACINE WI 53405 (262) 488-1300 JOSIE M GARCIA County: RACINE OAKWOOD COTTAGE (0013985) 7711 BIG BEND ROAD WATERFORD WI 53185 (262) 210-6189 JAN CAFLISCH County: RACINE

MENTOR ABI LLC (617) 790-4800 ANN MEEKS 5310 BUENA PARK RD WATERFORD WI 53185 NEW BEGINNINGS GROUP HOMES INC (262) 554-9566 NAN LENTZ 640 WOOD RD KENOSHA WI 53144 NEW BEGINNINGS GROUP HOMES INC (262) 554-9566 NAN LENTZ 640 WOOD RD KENOSHA WI 53144 NEW BEGINNINGS GROUP HOMES INC (262) 554-9566 NAN LENTZ 640 WOOD RD KENOSHA WI 53144 NEWMAN MANOR LLC (262) 488-1300 JOSIE M GARCIA 329 1/2 S NEWMAN RD RACINE WI 53406 ELDER CARE COTTAGES OF WISCONSIN (262) 210-6189 SHELLY SCHILLING 7711 BIG BEND RD WATERFORD WI 53185

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 1,062/1,062 Initial License: 11/08/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,585/2,890 Initial License: 02/01/1991

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,515/3,195 Initial License: 08/09/1996

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,893/3,345 Initial License: 07/01/2000

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF ANA Gender - Capacity: M/F - 8 Low/High rate: 2,160/2,460 Initial License: 02/01/2002

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,650/4,800 Initial License: 01/18/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 98

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 66 Low/High rate: 3,149/4,992 Initial License: 07/06/1999

Type: Class:

PINE BROOK POINTE (0008582) 1001 S PINE ST BURLINGTON WI 53105 (262) 767-1516 MARY PEARCE County: RACINE

PINE BROOK POINTE KDK DEVELOPMENT (262) 767-1516 MARY PEARCE 1001 S PINE ST BURLINGTON WI 53105

PROSPECT HEIGHTS COMMUNITY LIVING CENTER (000 2015 PROSPECT ST RACINE WI 53404 (262) 898-1029 RANDY MARVIN County: RACINE

PROSPECT HEIGHTS LLC (262) 898-1029 MARVIN RANDY 2015 PROSPECT ST RACINE WI 53404

Gender - Capacity:

CBRF ANA M/F - 52 Low/High rate: 1,927/1,927 Initial License: 04/04/2003

Type: Class:

ROLLING MEADOWS (0012246) 8212 RACINE AVE WIND LAKE WI 53185 (262) 895-3052 PAULA K HEYER County: RACINE

AFFINITY HEALTH CARE LLC (414) 303-8866 THOMAS R SCHILLING 8208 RACINE AVE WIND LAKE WI 53185

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,500/7,500 Initial License: 05/05/2008

Type: Class:

ROSEWOOD COTTAGE (0013984) 7711 BIG BEND ROAD WATERFORD WI 53185 (262) 210-6189 JAN CAFLISCH County: RACINE

ELDER CARE COTTAGES OF WISCONSIN (262) 210-6189 SHELLY SCHILLING 7711 BIG BEND RD WATERFORD WI 53185

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,650/4,800 Initial License: 01/18/2012

Type: Class:

SERENITY TERRACE LLC (0008997) 4606 W JOHNSON AVE RACINE WI 53405 (262) 930-8564 VIVIAN DEGRAVE County: RACINE ST MONICAS SENIOR CITIZENS HOME (310557) 3920 N GREEN BAY RD RACINE WI 53404 (262) 639-5050 LORETTA BAXTER County: RACINE STAFFORD MANOR (0012143) 4208 MARQUETTE DR RACINE WI 53402 (262) 639-4663 ROSE ESSER County: RACINE TIMBER OAKS (310564) 1390 8TH AVE UNION GROVE WI 53182 (262) 878-4899 VICKY SHARP County: RACINE Association Approval: WiCAL TLS BEHAVIORAL HEALTH (0013743) 3710 DOUGLAS AVE RACINE WI 53402 (262) 639-8084 JOHN CHIANELLI County: RACINE

SERENITY TERRACE LLC (262) 681-6562 VIVIAN DEGRAVE 4606 W JOHNSON AVE RACINE WI 53405 ST MONICAS SENIOR CITIZENS HOME INC (262) 639-5050 LORETTA BAXTER 3920 N GREEN BAY RD RACINE WI 53404 STAFFORD MANOR LLC (414) 588-8742 ROSE ESSER P O BOX 476 PEWAUKEE WI 53072-0476 GALLINA HEALTH CARE NETWORK LTD (262) 878-4899 BRUCE BARRETT 1390 8TH AVENUE UNION GROVE WI 53182 PEG DUBORD (414) 459-3007 JOHN CHIANELLI 3710 DOUGLAS AVE RACINE WI 53403

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,100/3,500 Initial License: 04/26/2000

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 110 Low/High rate: 1,263/2,832 Initial License: 10/16/1990

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,700/3,000 Initial License: 11/29/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,846/3,468 Initial License: 09/04/1991

Type: Class:

CBRF AA Gender - Capacity: M/F - 13 Low/High rate: 11,558/12,927 Initial License: 12/05/2011

Type: Class:

ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 99

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 31 Low/High rate: 4,800/6,000 Initial License: 06/29/2012

Type: Class:

WATERFORD MEMORY CARE LLC (0014008) 301 S SIXTH ST WATERFORD WI 53185 (262) 534-4800 MEGHAN GIESE County: RACINE WILLOWGREEN (0010177) 4719 KINGDOM CT RACINE WI 53402 (262) 681-7201 SCOTT CHAPPELL County: RACINE

WATERFORD MEMORY CARE LLC (262) 514-2904 SCOTT SHADEL 1903 ST GEORGE LN JANESVILLE WI 53545 WILLOWGREEN INC (262) 681-7201 SCOTT CHAPPELL 4719 KINGDOM CT RACINE WI 53402

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 2,400/2,900 Initial License: 10/27/2003

Type: Class:

WISCONSIN VETERANS HOME FAIRCHILD HALL (0009253) STATE OF WISCONSIN DEPT OF VETERANS AF (608) 266-1315 21425 SPRING ST #D REID AARON UNION GROVE WI 53182 21425 F SPRING ST (262) 878-6752 REID AARON UNION GROVE WI 53182 County: RACINE HARVEST GUEST HOME (110455) 875 WEST SIDE DR RICHLAND CENTER WI 53581 (608) 647-8205 JOSE D FLORES JR County: RICHLAND HOMESTEAD (THE) (110388) 13599 KANTON RD BLUE RIVER WI 53518 (608) 536-3480 DOROTHY KAUFMAN County: RICHLAND OUR HOUSE MEMORY CARE (0013379) 240 N ORANGE ST RICHLAND CENTER WI 53581 (608) 647-4533 AMANDA MAXWELL County: RICHLAND RIDGE VIEW HOME (0012589) 125 CUNNINGHAM RIDGE RD CAZENOVIA WI 53924 (608) 983-2443 DEBRA CARROLL County: RICHLAND JAYDEE ELDER CARE CORP (608) 647-8205 JOSE D FLORES JR 875 WEST SIDE DR RICHLAND CENTER WI 53581 B CARE CORPORATION (262) 275-6771 DOROTHY KAUFMANN PO BOX 409 FONTANA WI 53125 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 RIDGEVIEW HOMES LLC (608) 983-2443 DEBRA CARROLL 125 CUNNINGHAM RIDGE RD CAZENOVIA WI 53924

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 5,130/5,340 Initial License: 08/06/2001

Type: Class:

CBRF ANA Gender - Capacity: M/F - 17 Low/High rate: 3,220/3,500 Initial License: 01/17/1995

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,042/4,631 Initial License: 01/16/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 21 Low/High rate: 3,300/3,300 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 7 Low/High rate: 2,000/5,000 Initial License: 01/26/2009

Type: Class:

SAMARITAN HOUSE (110454) 875 WEST SIDE DR RICHLAND CENTER WI 53581 (608) 647-8205 JOSE D FLORES JR County: RICHLAND SCHMITT WOODLAND HILLS INC (110230) 1400 W SEMINARY ST RICHLAND CENTER WI 53581 (608) 647-8931 JOANNE AMELL County: RICHLAND Association Approval: Leading Age STEWART STREET CBRF (0014080) 204 S STEWART ST RICHLAND CENTER WI 53581 (608) 649-5275 CHASITY WALSH County: RICHLAND

JAYDEE ELDER CARE CORP (608) 647-8205 JOSE D FLORES JR 875 WEST SIDE DR RICHLAND CENTER WI 53581 SCHMITT WOODLAND HILLS INC (608) 647-8931 JAMES B OLSON 1400 W SEMINARY ST RICHLAND CENTER WI 53581 LORI KNAPP CRAWFORD INC (608) 326-5536 KELLY GOCHENAUR 106 S BEAUMONT RD PRAIRIE DU CHIEN WI 53821

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,220/3,600 Initial License: 01/17/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 3,829/5,383 Initial License: 01/31/1988

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,920/6,144 Initial License: 04/19/2012

Type: Class:

WILLIS SPRING ACRES (110336) 33834 SMYTH HOLLOW RD HILLPOINT WI 53937 (608) 986-6702 MARIE I WILLIS County: RICHLAND

MARIE & GAYLORD WILLIS (608) 986-6702 MARIE I WILLIS 33834 SMYTH HOLLOW RD HILLPOINT WI 53937

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,750/1,875 Initial License: 04/01/1992

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 100

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,300/3,600 Initial License: 06/01/2012

Type: Class:

ALCOCARE INC (0014145) 786 S MAIN ST JANESVILLE WI 53545 (608) 754-6800 TOM BOLAN County: ROCK ALCOCARE INC (0014247) 210 S JACKSON ST JANESVILLE WI 53548 (608) 754-6800 TOM BOLAN County: ROCK BEECHWOOD (0011374) 315 BEECHWOOD DRIVE JANESVILLE WI 53548 (608) 754-8121 LORI WERTH County: ROCK CEDAR CREST ASSISTED LIVING (0008495) 1704 S RIVER RD JANESVILLE WI 53546 (608) 756-0344 MARION WOZNIAK County: ROCK Association Approval: Leading Age COLLINWOOD ELDERLY CARE (0008631) 506 NORTH MAIN ST ORFORDVILLE WI 53576 (608) 879-3084 LOUANN HARMEL County: ROCK

ALCOCARE INC (608) 754-6800 TOM BOLAN 786 S MAIN ST JANESVILLE WI 53545 ALCOCARE INC (608) 754-6800 TOM BOLAN 210 S JACKSON ST JANESVILLE WI 53548 DUNGARVIN WISCONSIN LLC (608) 752-8363 LORI WERTH PO BOX 8124 JANESVILLE WI 53547 CEDAR CREST INC (608) 756-0344 MARION WOZNIAK 1702 S RIVER RD JANESVILLE WI 53546 DISCH ENTERPRISES LTD (608) 558-7290 LOUANN HARMEL N5219 CTY E ALBANY WI 53502

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,300/3,600 Initial License: 08/01/2012

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 6 Low/High rate: 3,729/3,729 Initial License: 03/31/2006

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 56 Low/High rate: 3,795/4,937 Initial License: 10/31/1998

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,800/3,800 Initial License: 04/23/1999

Type: Class:

COZY LIL ACRE INC (110468) 2210 MINERAL POINT AVE JANESVILLE WI 53545 (608) 752-2475 MARY SANDERS County: ROCK COZY LIL ACRE INC (0009460) 521 NORTH GRANT ST JANESVILLE WI 53548 (608) 758-1103 MARY SANDERS County: ROCK DUPONT (0011375) 1945 DUPONT DR JANESVILLE WI 53546 (608) 754-7573 LORI WERTH County: ROCK EMERALD HOUSE (110283) 10304 WAL ROCK COUNTY LINE RD WHITEWATER WI 53190 (262) 473-8407 MARK SCHROEDER County: ROCK GROUP LIVING HOME INC (110146) 1941 GERSHWIN DR JANESVILLE WI 53545 (608) 756-2065 JULIE POSPESCHIL County: ROCK HARBOR HOUSE BELOIT 12 (0013403) 2086 COLONY COURT BELOIT WI 53511 (608) 365-7470 CLAIRE MACLENNAN County: ROCK

COZY LIL ACRE INC (608) 754-2273 MARY SANDERS 2210 MINERAL POINT AVE JANESVILLE WI 53545 COZY LIL ACRE INC (608) 758-1103 MARY SANDERS 521 NORTH GRANT ST JANESVILLE WI 53548 DUNGARVIN WISCONSIN LLC (608) 752-8363 LORI WERTH PO BOX 8124 JANESVILLE WI 53547 PRODUCTIVE LIVING SYSTEMS INC (715) 831-3910 MARK SCHROEDER 806 E COMMERCIAL AVE WHITEWATER WI 53190-0650 GROUP LIVING HOME INC (608) 757-0595 JULIE POSPESCHIL 1204 VISTA AVENUE JANESVILLE WI 53545 AZURA BELOIT LLC (608) 365-7470 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562

CBRF CS Gender - Capacity: M/F - 13 Low/High rate: 2,520/3,621 Initial License: 06/01/1995

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,800/3,165 Initial License: 11/05/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,257/7,197 Initial License: 12/01/2006

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,567/5,567 Initial License: 05/30/1990

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 1,500/2,000 Initial License: 07/31/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 101

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

HARBOR HOUSE BELOIT 8 (0013407) 2096 COLONY COURT BELOIT WI 53511 (608) 365-7470 CLAIRE MACLENNAN County: ROCK HARBOR HOUSE CLINTON (0013406) 805 SUE LANE CLINTON WI 53525 (608) 676-4056 TRACY MCWILLIAM County: ROCK HARBOR HOUSE JANESVILLE (0013405) 719 HAWTHORNE DR JANESVILLE WI 53545 (608) 757-9300 CLAIRE MACLENNAN County: ROCK HEARTHSIDE (110252) 2203 HANCOCK LANE JANESVILLE WI 53545 (608) 757-2275 KATHLEEN WOLF County: ROCK HEARTWARMING HOUSE LLC (THE) (0013013) 238 EAST MADISON AVE MILTON WI 53563 (608) 868-3040 DOUGLAS HEARN County: ROCK HUNTINGTON PLACE MEMORY CARE 1 (0014094) 3828 E ROTAMER RD JANESVILLE WI 53546 (608) 868-5055 ANNA MCCARTHY County: ROCK HUNTINGTON PLACE MEMORY CARE 2 (0014095) 3840 E ROTAMER RD JANESVILLE WI 53546 (608) 868-5057 ANNA MCCARTHY County: ROCK HUNTINGTON PLACE MEMORY CARE 3 (0014097) 3902 E ROTAMER RD JANESVILLE WI 53546 (608) 868-2397 ANNA MCCARTHY County: ROCK KELLOGG (0011378) 1947 DUPONT DR JANESVILLE WI 53546 (608) 756-5733 LORI WERTH County: ROCK KELLY HOUSE (110260) 121 S 5TH ST EVANSVILLE WI 53536 (608) 882-4191 DIANE SKINNER County: ROCK

AZURA BELOIT 2 LLC (608) 365-7470 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562 AZURA CLINTON LLC (608) 676-4056 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562 AZURA JANESVILLE LLC (608) 757-9300 CARRIE ZOLADZ 6405 CENTURY AVE SUITE 104 MIDDLETON WI 53562 STONE RIDGE ESTATES INC (608) 754-2369 WILLIAM WOLF 1824 RIVERVIEW DRIVE JANESVILLE WI 53546 THE HEARTWARMING HOUSE LLC (608) 302-8288 DOUGLAS HEARN 238 E MADISON AVE MILTON WI 53563 FVE MW LLC (608) 868-5055 ANNA MCCARTHY 3828 E ROTAMER RD JANESVILLE WI 53546 FVE MW LLC (608) 868-5057 ANNA MCCARTHY 3840 E ROTAMER RD JANESVILLE WI 53546 FVE MW LLC (608) 868-2397 ANNA MCCARTHY 3902 E ROTAMER RD JANESVILLE WI 53546 DUNGARVIN WISCONSIN LLC (608) 752-8363 LORI WERTH PO BOX 8124 JANESVILLE WI 53547 DIANE SKINNER (608) 882-4191 DIANE SKINNER 121 SOUTH 5TH ST EVANSVILLE WI 53536

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,995/2,485 Initial License: 04/06/1989

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,900/5,500 Initial License: 05/04/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 11 Low/High rate: 4,413/4,928 Initial License: 04/13/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,413/4,928 Initial License: 04/13/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 4,413/4,928 Initial License: 04/13/2012

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,454/2,454 Initial License: 03/31/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,275/3,400 Initial License: 08/02/1989

Type: Class:

LEE LANE (0011380) 1620 LEE LANE JANESVILLE WI 53546 (608) 741-1663 LORI WERTH County: ROCK LSS CROSBY GROUP HOME (110250) 511 S CROSBY AVE JANESVILLE WI 53545 (608) 752-3921 JANE RAMSEY County: ROCK

DUNGARVIN WISCONSIN LLC (608) 752-8363 LORI WERTH PO BOX 8124 JANESVILLE WI 53547 LUTHERAN SOC SERV OF WI & UPPER MI INC (920) 730-1326 C/O PAULA UPP TED HAKALA 3003 N RICHMOND ST APPLETON WI 54911

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 7,188/8,408 Initial License: 03/31/2006

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 6 Low/High rate: 3,150/3,150 Initial License: 10/23/1990

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 102

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,310/4,060 Initial License: 09/30/2010

Type: Class:

OUR HOUSE ASSISTED CARE (0013378) 2516 GREEN VALLEY DR JANESVILLE WI 53546 (608) 756-1340 JULIA GILES County: ROCK OUR HOUSE MEMORY CARE (0013381) 4333 PHEASANT RUN RD JANESVILLE WI 53546 (608) 756-9030 JULIA GILES County: ROCK PIONEER COURT (110561) 2122 PIONEER DR BELOIT WI 53511 (608) 365-9451 LEE GUNDERSON County: ROCK REM CANTERBURY (110449) 3605/3607 CANTERBURY LA JANESVILLE WI 53546 (608) 752-0834 JULIE CHAMPION County: ROCK REM JONATHON (110458) 223 225 JONATHON DR JANESVILLE WI 53548 (608) 754-2412 JULIE CHAMPION County: ROCK REM WREN (0008927) 2008 WREN DR BELOIT WI 53511 (608) 365-4109 JULIE CHAMPION County: ROCK ROCK VALLEY COMM PROG INC CRISIS UNIT (0014440) 203 W SUNNY LANE RD JANESVILLE WI 53546 (608) 741-4500 ANGELA EGGERS County: ROCK ROCK VALLEY COMMUNITY PROGRAMS INC (111054) 203 WEST SUNNY LANE RD JANESVILLE WI 53546 (608) 741-4500 ANGELA EGGERS County: ROCK SHERMAN HOME (THE) (110107) 1321 SHERMAN AVE JANESVILLE WI 53545 (608) 752-3711 PATRICIA A HUBBARD County: ROCK

KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 PIONEER COURT INC (608) 365-9451 LEE GUNDERSON 2122 PIONEER DR BELOIT WI 53511 REM WISCONSIN II INC (608) 276-1191 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 REM WISCONSIN II INC (608) 276-1191 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 REM WISCONSIN II INC (608) 276-1191 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 ROCK VALLEY COMMUNITY PROGRAMS INC (608) 741-4500 ANGELA EGGERS 203 W SUNNY LANE RD JANESVILLE WI 53546 ROCK VALLEY COMMUNITY PROGRAMS INC (608) 741-4500 ANGELA EGGERS 203 WEST SUNNY LANE RD JANESVILLE WI 53546 CARTOGRAPHICS CORPORATION (608) 758-3324 PATRICIA A HUBBARD 1519 W COURT ST JANESVILLE WI 53548

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,600/3,830 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 54 Low/High rate: 3,045/4,920 Initial License: 09/18/1996

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 6,848/6,867 Initial License: 12/30/1994

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 5,796/5,857 Initial License: 02/01/1995

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 5 Low/High rate: 3,608/3,991 Initial License: 01/27/2000

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 4,700/5,833 Initial License: 02/01/2013

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

Gender - Capacity:

CBRF CNA M/F - 100 Low/High rate: 2,311/3,069 Initial License: 12/31/1997

Type: Class:

CORRECTIONAL CLIENTS

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 2,300/3,100 Initial License: 02/28/1987

Type: Class:

ST ELIZABETH MANOR (0012686) 111 COMMERCIAL DR FOOTVILLE WI 53537 (608) 876-4000 SR KATHERINE GRUBER County: ROCK SUN VALLEY HOMES LLC EAST I (0010973) 2775 KADLEC DR BELOIT WI 53511 (608) 362-8092 JAIME VALENTIN County: ROCK

MOTHER MARY CHRISTOPHER LEMIRE (608) 876-4000 MOTHER MARY CHRISTOPHER LEMIRE PO BOX 217 FOOTVILLE WI 53537 SUN VALLEY HOMES LLC (608) 365-0076 PENNI L FRANK 4200 PIERCE AVE LOT 561 MARINETTE WI 54143

CBRF CNA Gender - Capacity: M/F - 80 Low/High rate: 3,350/4,400 Initial License: 04/06/2009

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 10 Low/High rate: 3,650/4,200 Initial License: 05/23/2005

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 103

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,650/5,400 Initial License: 05/23/2005

Type: Class:

SUN VALLEY HOMES LLC EAST II (0010972) 2775 KADLEC DR BELOIT WI 53511 (608) 362-8094 JAIME VALENTIN County: ROCK SUN VALLEY HOMES LLC TERRACE (0010974) 2771 IVA COURT BELOIT WI 53511 (608) 365-3737 JAIME VALENTIN County: ROCK SUN VALLEY HOMES LLC WEST (0010970) 2156 HOUSE ST BELOIT WI 53511 (608) 365-7455 MANDIE BISHOP County: ROCK SUN VALLEY HOMES NORTH (0011787) 2027 COLONY COURT BELOIT WI 53511 (608) 361-6990 JAIME VALENTIN County: ROCK WOODS CROSSING AT WOODS POINT (0010939) E401 23RD ST BRODHEAD WI 53520 (608) 897-3031 LEE GUNDERSON County: ROCK WRIGHT HOME (110210) 637 N WRIGHT RD JANESVILLE WI 53546 (608) 756-5807 PATRICIA HUBBARD County: ROCK

SUN VALLEY HOMES LLC (608) 208-0269 PENNI L FRANK 4200 PIERCE AVE LOT 561 MARINETTE WI 54143 SUN VALLEY HOMES LLC (608) 208-0269 PENNI L FRANK 4200 PIERCE AVE LOT 561 MARINETTE WI 54143 SUN VALLEY HOMES LLC (608) 208-0269 PENNI L FRANK 4200 PIERCE AVE LOT 561 MARINETTE WI 54143 SUN VALLEY HOMES LLC (608) 208-0269 PENNI FRANK 4200 PIERCE AVE LOT 561 MARINETTE WI 54143 WOODS POINT MANAGEMENT INC (608) 897-3031 LEE GUNDERSON E 401 23RD ST BRODHEAD WI 53520 CARTOGRAPHICS CORP (608) 758-3324 PATRICIA HUBBARD 1519 W COURT ST JANESVILLE WI 53548

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,200/5,400 Initial License: 05/23/2005

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,200/4,500 Initial License: 05/23/2005 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,300/4,300 Initial License: 03/23/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 2,780/4,150 Initial License: 07/01/2005

Type: Class:

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 2,115/2,800 Initial License: 11/30/1990

Type: Class:

CARE PARTNERS ASSISTED LIVING - LADYSMITH (00126 1105 BAKER AVE LADYSMITH WI 54848 (715) 532-0818 BETH PETERSON County: RUSK COUNTRY TERRACE LADYSMITH (0009673) 910 SHADY LANE LADYSMITH WI 54848 (715) 532-6993 BETH PETERSON County: RUSK LAKE MANOR (510330) 119 E 4TH ST N LADYSMITH WI 54848 (715) 532-6090 CHERYL KELLEY County: RUSK Association Approval: WiCAL AMERICANWAY OF SAUK COUNTY LLC (0013460) S7559 US HWY 12 NORTH FREEDOM WI 53951 (608) 643-2232 STEPHANIE PASCIAK County: SAUK

CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903-3006

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,200/4,000 Initial License: 01/01/2009

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 2,600/3,600 Initial License: 09/06/2002

Type: Class: Type: Class:

(715) 532-6090 CHERYL KELLEY 119 E 4TH ST N LADYSMITH WI 54848 AMERICANWAY OF SAUK COUNTY LLC (608) 566-1500 JANIS DEETS NOWAK 602 E ALBERT ST SUITE 3 PORTAGE WI 53901

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,192/8,179 Initial License: 07/01/1991 CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 2,000/3,500 Initial License: 01/26/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 104

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,800/4,700 Initial License: 12/01/2012

Type: Class:

ARTISAN BARABOO I (THE) (0014451) 1200 SILVER DRIVE BARABOO WI 53913 (608) 356-4837 SUE FUNK County: SAUK ARTISAN BARABOO II (THE) (0014424) 1114 SILVER DRIVE BARABOO WI 53913 (608) 356-4837 SUE FUNK County: SAUK CASA DE OAKES (0008972) E6846 FAWN VALLEY DR REEDSBURG WI 53959 (608) 524-2283 REBECCA J KNULL County: SAUK CASA DE OAKES INC BARABOO (0012391) 717 JEFFERSON ST BARABOO WI 53913 (608) 356-9762 REBECCA J KNULL County: SAUK CASA DE OAKES INC REEDSBURG (0012392) 201 SOUTH GROVE ST REEDSBURG WI 53959 (608) 524-6254 REBECCA J KNULL County: SAUK COUNTRY CASA (0010325) E8509 N REEDSBURG RD REEDSBURG WI 53959 (608) 524-8054 CAROL L MOE KIEFER County: SAUK MEADOW LANE (110191) 1414 JEFFERSON ST BARABOO WI 53913 (608) 355-3325 SHELLY DEYO County: SAUK Association Approval: Leading Age MEADOW RIDGE ASSISTED LIVING LLC (0009753) 1700 JEFFERSON ST BARABOO WI 53913 (608) 356-8770 JEAN LUETKENS County: SAUK

MOSAIC MANAGEMENT GROUP LLC (608) 221-8007 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 MOSAIC MANAGEMENT GROUP LLC (608) 221-8007 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 CASA DE OAKES INC (608) 524-9876 REBECCA J KNULL 617 E MAIN ST REEDSBURG WI 53959 CASA DE OAKES INC (608) 524-9876 REBECCA J KNULL 617 E MAIN ST REEDSBURG WI 53959 CASA DE OAKES INC (608) 524-9876 REBECCA KNULL 617 E MAIN REEDSBURG WI 53959 CAROL L MOE KIEFER (608) 524-9729 CAROL L MOE KIEFER E6844 FAWN VALLEY RD REEDSBURG WI 53959 SSM HEALTH CARE OF WISCONSIN INC (608) 258-6120 RONNIE SCHAETZL 1414 JEFFERSON ST BARABOO WI 53913 ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY L GRIFFIN 1402 PANKRATZ ST MADISON WI 53704

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,800/4,700 Initial License: 12/01/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,957/3,732 Initial License: 05/01/2000

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,000 Initial License: 07/01/2008

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,500 Initial License: 07/01/2008

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF ANA Gender - Capacity: M/F - 8 Low/High rate: 2,250/2,373 Initial License: 11/06/2003

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 2,900/3,406 Initial License: 01/01/1986

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,810/4,110 Initial License: 09/17/2002

Type: Class:

MEADOW VIEW (0011486) 1600 JEFFERSON ST BARABOO WI 53913 (608) 356-2944 JEAN LUETKENS County: SAUK MEADOWS OF SPRING GREEN (THE) (110558) 477 RAINBOW RD SPRING GREEN WI 53588 (608) 588-2101 CARRIE GEORGESON County: SAUK NARROWS (THE) (0010107) E4796 NARROWS CREEK RD LOGANVILLE WI 53943 (608) 727-2259 KIMBERLY M SLAMA County: SAUK

ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY GRIFFIN 1402 PANKRATZ ST MADISON WI 53704 ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREG GRIFFIN 1402 PANKRATZ RD STE 110 MADISON WI 53704 KIMBERLY SLAMA AND DANIEL STOLTE (608) 727-2259 KIMBERLY M SLAMA E4796 NARROWS CREEK RD LOGANVILLE WI 53943

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 4,200/4,500 Initial License: 06/29/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 3,510/4,260 Initial License: 12/09/1996

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,575/3,500 Initial License: 09/09/2003

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 105

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,350/3,850 Initial License: 11/19/2008

Type: Class:

OAK PARK PLACE BARABOO AUTUMN LANE (0012510) 800 WALDO ST BARABOO WI 53913 (608) 355-4111 TONI CARRUTHERS County: SAUK OUR HOUSE ASSISTED CARE (0013375) 1135 17TH COURT REEDSBURG WI 53959 (608) 524-1321 BLANCHE WELLMAN County: SAUK OUR HOUSE ASSISTED CARE (0013376) 1200 WASHINGTON AVE BARABOO WI 53913 (608) 355-2344 MANDY PAYNE County: SAUK OUR HOUSE SENIOR LIVING (0013666) 355 MACK DR REEDSBURG WI 53959 (608) 524-6116 MICHELLE MEARS County: SAUK PINE VILLA (0009311) 950 PRAIRIE ST PRAIRIE DU SAC WI 53578 (608) 643-7343 NANCY PECK County: SAUK PINES ASSISTED LIVING (THE) (110462) 1050 PRAIRIE ST PRAIRIE DU SAC WI 53578 (608) 643-5433 NANCY PECK County: SAUK CARE PARTNERS ASSISTED LVG HAYWARD (0009028) 15497 PINEWOOD DRIVE HAYWARD WI 54843 (715) 634-5767 DEB SCHIRO County: SAWYER

OAK PARK PLACE OF BARABOO LLC (608) 663-8606 TONI CARRUTHERS 719 JUPITER DR MADISON WI 53718 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY L GRIFFIN 1402 PANKRATZ ST STE 110 MADISON WI 53704 ELDERSPAN MANAGEMENT LLC (608) 243-8800 GREGORY L GRIFFIN 1402 PANKRATZ RD STE 110 MADISON WI 53704 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54902

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,700/2,700 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,200/3,950 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,850/4,950 Initial License: 04/15/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 3,990/4,290 Initial License: 05/01/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 27 Low/High rate: 3,600/3,900 Initial License: 12/31/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 2,022/3,645 Initial License: 05/21/2000

Type: Class:

COUNTRY TERRACE - HAYWARD (0012899) 10260 WHITE BIRCH LANE HAYWARD WI 54843 (715) 634-1447 ROBIN HELLAND County: SAWYER LCO HALFWAY HOUSE (0009818) 12929 W HASKINS RD HAYWARD WI 54843 (715) 634-5841 DOROTHY CRUST County: SAWYER QUEEN OF ANGELS CONVENT AND CBRF (610287) 11428 WEST STATE ROAD 27/70 RADISSON WI 54867-7006 (715) 945-2203 MARY HILDEBRAND County: SAWYER SUNSET SENIOR HOME (0011017) 15495 CTY RD B HAYWARD WI 54843 (715) 634-2641 LEIGH HUBBARD-WILT County: SAWYER

COUNTRY TERRACE OF WISCONSIN LLC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 LAC COURTE OREILLES TRIBAL GOVERNMENT (715) 634-8934 LOUIS TAYLOR 13394 WEST TREPANIA ROAD HAYWARD WI 54843 ORDER OF ST FRANCIS OF ASSISI INC (715) 945-2203 MARY HILDEBRAND 11428 WEST STATE ROAD 27/70 RADISSON WI 54867-7006 TIP LYNN CORP (715) 634-2641 LEIGH HUBBARD-WILT 15495 W CTY RD B HAYWARD WI 54843

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,400/4,200 Initial License: 08/01/2009

Type: Class:

CBRF AA Gender - Capacity: M - 20 Low/High rate: 1,698/1,698 Initial License: 07/16/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 2,600/2,600 Initial License: 12/01/1994

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,320/2,790 Initial License: 06/17/2005

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 106

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,568/4,409 Initial License: 04/26/2010

Type: Class:

TRANSITIONS (0012868) 16208 WOODRIDGE LANE HAYWARD WI 54843 (715) 638-3232 JOE BODO County: SAWYER AUTUMN LANE FAMILY CARE (0011590) 384 LYONS ROAD BIRNAMWOOD WI 54414 (715) 449-3444 TRACY ANDERSON County: SHAWANO

SAWYER COUNTY HEALTH AND HUMAN SERV (715) 634-4806 PETE SANDERS 10610 MAIN ST, SUITE 224 HAYWARD WI 54843 SALLY RIPLEY (715) 449-3177 SALLY RIPLEY PO BOX 220 BIRNAMWOOD WI 54414

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,200/3,500 Initial License: 08/14/2006

Type: Class:

BOHLMAN MANOR INC (0010931) 401 CENTER STREET BIRNAMWOOD WI 54414 (715) 449-9626 PAMELA DAFFRON County: SHAWANO

PAMELA DAFFRON (715) 253-2754 PAMELA DAFFRON PO BOX 250 BIRNAMWOOD WI 54414

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,200/4,000 Initial License: 08/16/2005

Type: Class:

CADY MEMORIAL HOME (410148) 380 MAPLE STREET BIRNAMWOOD WI 54414 (715) 449-3177 TRACY ANDERSON County: SHAWANO COTTAGES MEMORY CARE THE (0014369) 113 MADISON WAY SHAWANO WI 54166 (715) 526-5166 CARA PETERSON County: SHAWANO ELLA BESAW CENTER (410245) N8697 MOH-HE-CON-NUCK ROAD BOWLER WI 54416 (715) 793-4537 SHIRLEY METOXEN County: SHAWANO HOMME RESIDENTIAL WITTENBERG (410107) 604 SOUTH WEBB STREET WITTENBERG WI 54499 (715) 253-2125 ARLENE HANUS County: SHAWANO

(715) 449-3177 SALLY RIPLEY PO BOX 220 BIRNAMWOOD WI 54414-0220 THE COTTAGES INVESTMENT GROUP LLC (715) 526-5166 CARA PETERSON 103 MADISON WAY SHAWANO WI 54166 STOCKBRIDGE MUNSEE COMMUNITY (715) 793-4111 SHIRLEY METOXEN PO BOX 70 BOWLER WI 54416 HOMME HOME FOR THE AGING INC (715) 253-2125 ARLENE HANUS 604 SOUTH WEBB STREET WITTENBERG WI 54499

CBRF CNA Gender - Capacity: M/F - 13 Low/High rate: 1,937/4,000 Initial License: 01/01/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 3,600/4,700 Initial License: 10/25/2012

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 334/3,224 Initial License: 02/15/1991

Type: Class:

ADVANCED AGED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 44 Low/High rate: 2,415/3,295 Initial License: 08/02/1980

Type: Class:

KINDREDHEARTS SHAWANO (0009722) 1377 LINCOLN STREET SHAWANO WI 54166 (715) 524-6711 DEB TALLEY County: SHAWANO LSS HOMME YOUTH ACCEPTANCE (0009890) W18105 HEMLOCK ROAD WITTENBERG WI 54499 (715) 253-2116 TARA TREGLOWNE County: SHAWANO LSS HOMME YOUTH JOURNEY SOUTH UNIT (0009415) W17985 HEMLOCK ROAD WITTENBERG WI 54499 (715) 253-2116 KARIE KOPPA County: SHAWANO

PARTNERS IN COMMUNITY ELDERCARE LLC (608) 422-8005 DEB TALLEY 1377 LINCOLN STREET SHAWANO WI 54166 LUTHERAN SOC SERV OF WI & UPPER MI INC (414) 281-4400 TARA TREGLOWNE W18105 HEMLOCK ROAD WITTENBERG WI 54499 LUTHERAN SOC SERV OF WI & UPPER MI INC (414) 281-4400 TARA TREGLOWNE W18105 HEMLOCK ROAD WITTENBERG WI 54499

Gender - Capacity:

CBRF CNA M/F - 16 Low/High rate: 2,940/3,270 Initial License: 10/02/2002

Type: Class:

Gender - Capacity:

CBRF AA M - 19 Low/High rate: 6,661/9,673 Initial License: 12/16/2002

Type: Class:

CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS CORRECTIONAL CLIENTS PUBLIC FUNDING

Gender - Capacity:

CBRF AA F - 16 Low/High rate: 6,661/9,673 Initial License: 10/02/2001

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 107

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AS Gender - Capacity: M/F - 16 Low/High rate: 2,129/2,129 Initial License: 07/01/1986

Type: Class:

MAEHNOWESEKIYAH WELLNESS CENTER (410032) N2150 KESAEHKAHTEK GRESHAM WI 54128 (715) 799-3835 SHANNON WILBER County: SHAWANO MEADOW VIEW CARE FACILITY (0009093) 400 WEST MILL STREET BONDUEL WI 54107 (715) 758-1992 ANNITA WEBER County: SHAWANO PAISERS OAKHAVEN LLC (0009685) 132 OAK COURT SHAWANO WI 54166 (715) 526-3324 VICTORIA PAISER County: SHAWANO PAISERS OAKHAVEN LLC BLDG II (0012435) 142 OAK COURT SHAWANO WI 54166 (715) 526-3324 VICTORIA PAISER County: SHAWANO WOLF RIVER CBRF (0011326) N2222 WHITE CEDAR ROAD NEOPIT WI 54150 (715) 799-5240 GAIL HANSETER County: SHAWANO ARBOR VIEW COMMUNITIES (0012262) 1900 ARBOR VIEW DR PLYMOUTH WI 53073 (920) 893-4200 MANDI STELLOH County: SHEBOYGAN BANCROFT HAUS OF HARVEST HOME SR LIVING SERV ( 2005 APPLETREE RD HOWARDS GROVE WI 53083 (920) 550-3018 BETH PAHMEIER County: SHEBOYGAN BRAEBURN HAUS OF HARVEST HOME SR LIVING SERV ( 2003 APPLETREE RD HOWARDS GROVE WI 53083 (920) 550-3020 BETH PAHMEIER County: SHEBOYGAN CEDAR GROVE GARDENS I (0012460) 606 VAN ALTENA AVE CEDAR GROVE WI 53013 (920) 668-6400 MARY M READ County: SHEBOYGAN CEDAR GROVE GARDENS II (0012461) 626 VAN ALTENA AVE CEDAR GROVE WI 53013 (920) 668-8600 MARY M READ County: SHEBOYGAN COUNTRYSIDE MANOR (0011462) 4221 KADLEC DRIVE SHEBOYGAN WI 53081 (920) 452-2229 ANGELA OKOROMA County: SHEBOYGAN COUNTRYSIDE MANOR WEST (0011501) 4228 KADLEC DRIVE SHEBOYGAN WI 53083 (920) 452-2229 ANGELA OKOROMA County: SHEBOYGAN

MENOMINEE INDIAN TRIBE OF WISCONSIN (715) 799-3835 SHANNON WILBER N2150 KESAEHKAHTEK GRESHAM WI 54128 (920) 498-1772 ANNITA WEBER 2144 BALSAM WAY GREEN BAY WI 54313 PAISERS OAKHAVEN LLC (715) 787-4385 VICTORIA PAISER N6490 BLUEBERRY ROAD GRESHAM WI 54128 VICTORIA PAISER (715) 787-4385 VICTORIA PAISER N6490 BLUEBERRY ROAD GRESHAM WI 54128 MENOMINEE INDIAN TRIBE OF WISCONSIN (715) 799-5154 GAIL HANSETER PO BOX 910 KESHENA WI 54135 K J LIVING LLC (920) 960-4694 MANDI STELLOH 1900 ARBOR VIEW DR PLYMOUTH WI 53073 HARVEST HOME SENIOR LIVING SERVICES INC (920) 901-9482 BETH PAHMEIER 1007 N WISCONSIN DR HOWARDS GROVE WI 53083 HARVEST HOME SENIOR LIVING SERVICES INC (920) 901-9482 BETH PAHMEIER 1007 N WISCONSIN DR HOWARDS GROVE WI 53083 SANDVIEW LLC (262) 873-0034 MARY READ 1698 AQUA VIEW CT CEDARBURG WI 53012-9146 SANDVIEW LLC (262) 873-0034 MARY READ 1698 AQUA VIEW CT CEDARBURG WI 53012-9146 COUNTRYSIDE CRL LLC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVE STE 3740 CHICAGO IL 60611 COUNTRYSIDE CRL LLC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVE STE 3740 CHICAGO IL 60611

ALCOHOL/DRUG DEPENDENT

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,200/2,500 Initial License: 08/01/2000

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 15 Low/High rate: 2,479/3,200 Initial License: 09/12/2002

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,700/3,200 Initial License: 07/17/2008

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 1,500/3,086 Initial License: 02/10/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,250/5,000 Initial License: 04/01/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,895/4,495 Initial License: 07/31/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,895/4,495 Initial License: 07/31/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/5,000 Initial License: 08/01/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,500/5,000 Initial License: 08/01/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,300/4,750 Initial License: 05/05/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 63 Low/High rate: 3,500/7,040 Initial License: 06/20/2006

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 108

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,576/4,590 Initial License: 02/01/2006

Type: Class:

GABLES OF WALDO (0011321) 1102 W 1ST ST WALDO WI 53093 (920) 528-8800 PAMELA ZASTROW County: SHEBOYGAN GABLES ON THE POND (410556) 305 S SPRING ST RANDOM LAKE WI 53075 (920) 994-8304 PAM ZASTROW County: SHEBOYGAN

MUELZAST LLC DBA GABLES OF WALDO (920) 994-8304 PAMELA ZASTROW 305 S SPRING ST RANDOM LAKE WI 53093 MUELLER FAMILY CARE LIVING LLC (920) 994-8304 PAM ZASTROW 305 S SPRING ST RANDOM LAKE WI 53075

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,850/4,576 Initial License: 10/01/1999

Type: Class:

GABLES ON THE POND II (0009646) 305A S SPRING ST RANDOM LAKE WI 53075 (920) 994-8304 PAM ZASTROW County: SHEBOYGAN

MUELLER FAMILY CARE LIVING LLC (920) 994-8304 PAM ZASTROW 305A SPRING ST RANDOM LAKE WI 53075

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 4,215/4,760 Initial License: 08/14/2002

Type: Class:

GENESIS SHEBOYGAN RESIDENTIAL CENTER (410465) 503 WISCONSIN AVE SHEBOYGAN WI 53081 (920) 457-7802 PAULINE ORTLOFF County: SHEBOYGAN GOLDEN HARBOR LLC (0013780) 505 S WATER ST SHEBOYGAN WI 53081 (920) 451-6923 LINDA VOIGHT County: SHEBOYGAN

GENESIS BEHAVIORAL SERVICES INC (414) 777-1570 GINA SINGLETERY 6737 W WASHINGTON ST STE 2210 WEST ALLIS WI 53214 GOLDEN HARBOR LLC (414) 940-6608 JOHN TERESINSKI 18110 W BLUEMOUND RD #4 LOWER BROOKFIELD WI 53045

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,700/2,833 Initial License: 06/01/1990

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 2,600/4,900 Initial License: 08/31/2011

Type: Class:

HARBOR HOUSE SHEBOYGAN 19 (0013433) 2629 INDIANA AVE SHEBOYGAN WI 53081 (920) 452-7171 DONALD MURPHY County: SHEBOYGAN HARBOR HOUSE SHEBOYGAN 8 (0013434) 2611 INDIANA AVE SHEBOYGAN WI 53081 (920) 452-7171 DONALD MURPHY County: SHEBOYGAN HARMONY OF SHEBOYGAN EAST (0008709) 3315 SUPERIOR AVE SHEBOYGAN WI 53081 (920) 457-4000 JANET BELL County: SHEBOYGAN Association Approval: WiCAL HARMONY OF SHEBOYGAN WEST (0008711) 3319 SUPERIOR AVE SHEBOYGAN WI 53081 (920) 457-4036 JANET BELL County: SHEBOYGAN Association Approval: WiCAL HIL KAUFMANN HOME (0009736) 2307 N 30TH ST SHEBOYGAN WI 53083 (920) 457-6053 MICHELE WANGEMANN County: SHEBOYGAN

AZURA SHEBOYGAN LLC (920) 452-7171 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 AZURA SHEBOYGAN 2 LLC (920) 452-7171 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 52 Low/High rate: 3,090/4,470 Initial License: 07/01/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 3,090/3,600 Initial License: 07/01/1999

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 7,771/7,771 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 109

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,547/5,547 Initial License: 06/14/2004

Type: Class:

HIL NEW HORIZONS (0010603) 1411 N 26TH ST SHEBOYGAN WI 53081 (920) 457-6768 MICHELE WANGEMANN County: SHEBOYGAN HIL PRAIRIE VIEW (0009737) 4545 PRAIRIE VIEW RD SHEBOYGAN WI 53081 (920) 457-5154 BRUCE LISIECKI County: SHEBOYGAN HOMETOWN RETIREMENT SHEBOYGAN HOME (410464) 920 N 26TH ST SHEBOYGAN WI 53081 (920) 452-5554 TIM HERR County: SHEBOYGAN KINDREDHEARTS PLYMOUTH (0009719) 112 S RIVER BLVD PLYMOUTH WI 53073 (920) 893-8334 STEPHANIE ZASTROW County: SHEBOYGAN LIBBYS HOUSE (0012083) 2581 VALLEY RD PLYMOUTH WI 53073 (920) 893-2754 CHRISTINE THILL County: SHEBOYGAN Association Approval: WALA LIBBYS HOUSE EAST (0012495) 2653 VALLEY RD PLYMOUTH WI 53073 (920) 892-8324 CHRISTINE THILL County: SHEBOYGAN Association Approval: WALA LIBBYS HOUSE NORTH LLC (0013248) 2586 VALLEY RD PLYMOUTH WI 53073 (920) 892-8324 CHRISTINE THILL County: SHEBOYGAN Association Approval: WALA LSS TURNING POINT FACILITY (0012142) 1202 N 31ST ST SHEBOYGAN WI 53081 (920) 458-6188 LISA SEVERSON County: SHEBOYGAN OUR PLACE (410471) 1117 CLARA AVE SHEBOYGAN WI 53081 (920) 459-8287 TOM SCHROEDL County: SHEBOYGAN PINE HAVEN CHRISTIAN COMMUNITIES - OOSTBURG (00 701 PINE DR OOSTBURG WI 53070 (920) 564-6800 RONALD WALVOORT County: SHEBOYGAN Association Approval: Leading Age PINE HAVEN CHRISTIAN HOME (410472) 531 GIDDINGS AVE SHEBOYGAN FALLS WI 53085 (920) 467-2401 RONALD WALVOORT County: SHEBOYGAN Association Approval: Leading Age

HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5515 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMETOWN RETIREMENT INC (920) 908-8886 TIM HERR 920 N 26TH ST SHEBOYGAN WI 53081 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 STEPHANIE ZASTROW 112 S RIVER BLVD PLYMOUTH WI 53073 MEMORY GARDENS LLC (920) 946-7627 CHRISTINE THILL 2581 VALLEY RD PLYMOUTH WI 53073 MEMORY PATHWAYS LLC (920) 946-7627 CHRISTINE THILL 2653 VALLEY RD PLYMOUTH WI 53073 LIBBY'S HOUSE NORTH LLC (920) 892-8324 CHRISTINE THILL 2653 VALLEY RD PLYMOUTH WI 53073 LUTHERAN SOC SERV OF WI & UPPER MI INC (920) 730-1337 LISA SEVERSON 3003-A N RICHMOND ST APPLETON WI 54911 MENTAL HEALTH SERVICES INC (920) 459-8287 TOM SCHROEDL 1117 CLARA AVE SHEBOYGAN WI 53081 PINE HAVEN CHRISTIAN HOME INC (920) 467-2401 RONALD WALVOORT 531 GIDDINGS AVE SHEBOYGAN FALLS WI 53070 PINE HAVEN CHRISTIAN HOME INC (920) 467-2401 RONALD WALVOORT 531 GIDDINGS AVE SHEBOYGAN FALLS WI 53085

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 5 Low/High rate: 5,742/5,742 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AS Gender - Capacity: M/F - 13 Low/High rate: 2,400/2,750 Initial License: 10/01/1987

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,250/3,355 Initial License: 10/02/2002

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 4,590/5,355 Initial License: 09/18/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 4,500/5,250 Initial License: 09/26/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 34 Low/High rate: 4,350/8,200 Initial License: 06/01/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 15 Low/High rate: 3,579/3,579 Initial License: 02/25/2008

Type: Class:

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 14 Low/High rate: 1,809/1,809 Initial License: 06/01/1982

Type: Class:

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 2,790/3,390 Initial License: 12/31/2009

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 140 Low/High rate: 2,558/3,578 Initial License: 08/01/1986

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 110

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,268/2,268 Initial License: 02/01/1980

Type: Class:

REBOS MANOR (410473) 908 JEFFERSON AVE SHEBOYGAN WI 53081 (920) 452-6492 THOMAS SCHROEDL County: SHEBOYGAN SHEBOYGAN CO HALFWAY HOUSE (410480) 503 ONTARIO AVE SHEBOYGAN WI 53081 (920) 458-5205 MICHAEL SALERNO County: SHEBOYGAN SHEBOYGAN SENIOR COMMUNITY INC (410474) 930 N 6TH ST SHEBOYGAN WI 53081 (920) 458-2137 MICHAEL BASCH County: SHEBOYGAN Association Approval: Leading Age TLC NORTH 33RD PLACE (0009340) 1536 N 33RD PLACE SHEBOYGAN WI 53081 (920) 457-1769 TIM FREY County: SHEBOYGAN WILLOWGLEN ACADEMY WILSON (0009016) 3603 S BUSINESS DR SHEBOYGAN WI 53081 (920) 458-6640 DON MURPHY County: SHEBOYGAN WOODLAND MANOR (0009403) 851 FOND DU LAC AVE SHEBOYGAN FALLS WI 53085 (920) 467-6270 ANGELA OKOROMA County: SHEBOYGAN ARTHUR-ROSE LLC (0011898) 1164 HWY 64 NEW RICHMOND WI 54017 (715) 246-0800 JESSA NELSON County: ST CROIX AURORA RES ALT NEW RICHMOND 005 (510214) 1710 COUNTY ROAD A NEW RICHMOND WI 54017 (715) 246-4011 JILL MATTSON County: ST CROIX AURORA RES ALTERNATIVES INC 075 (0008753) 1740 6TH AVENUE BALDWIN WI 54002 (715) 684-3162 SARAH SCHEERINGA County: ST CROIX AURORA RES ALTERNATIVES INC 033 (0009230) 230 CO ROAD SS RIVER FALLS WI 54022 (715) 425-9215 TOM PEDERSON County: ST CROIX AURORA RES ALTERNATIVES INC 099 (0009334) 670 SYCAMORE DRIVE NEW RICHMOND WI 54017 (715) 246-3155 SARAH SCHEERINGA County: ST CROIX AURORA RESIDENTIAL ALTERNATIVES #023 (0011656) 1760 SIXTH AVE BALDWIN WI 54002 (715) 684-2728 SARAH SCHEERINGA County: ST CROIX

MENTAL HEALTH SERVICES INC (920) 459-8287 THOMAS SCHROEDL 1117 CLARA AVE SHEBOYGAN WI 53081 SHEBOYGAN COUNTY HALFWAY HOUSE INC (920) 458-5205 DIANNE KRAFT 503 ONTARIO AVE SHEBOYGAN WI 53081 SHEBOYGAN SENIOR COMMUNITY INC (920) 458-2127 MICHAEL BASCH 930 N 6TH ST SHEBOYGAN WI 53081 TLC HOMES INC (920) 457-0826 TIM FREY PO BOX 1407 SHEBOYGAN WI 53082-1407 PHOENIX CARE SYSTEMS INC (866) 225-4459 LA KELVIN B HILL 1744 N FARWELL AVE MILWAUKEE WI 53202 COMMUNITY RETIREMENT LIVING INC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVE STE 3740 CHICAGO IL 60611 ARTHUR-ROSE LLC (715) 246-0800 JESSA NELSON P O BOX 474 NEW RICHMOND WI 54017-0474 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DRIVE E MENOMONIE WI 54751 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 1,429/1,429 Initial License: 06/01/1979

Type: Class:

CBRF CNA Gender - Capacity: M/F - 65 Low/High rate: 2,340/4,965 Initial License: 10/01/1979

Type: Class:

ADVANCED AGED CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,000/6,000 Initial License: 06/01/2001

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 7,981/7,981 Initial License: 05/15/2000

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,995/4,330 Initial License: 08/26/2001

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 6,500/6,500 Initial License: 06/11/2007

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,806/7,011 Initial License: 03/01/1980

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,255/8,544 Initial License: 10/01/1999

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M - 8 Low/High rate: 3,053/7,385 Initial License: 02/27/2001

Type: Class:

CBRF CA Gender - Capacity: F - 5 Low/High rate: 2,485/7,376 Initial License: 07/01/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,106/6,802 Initial License: 10/11/2006

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 111

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 2,386/2,887 Initial License: 06/03/2010

Type: Class:

AURORA RESIDENTIAL ALTERNATIVES INC #030 (00132 760 WILFRED RD APT B HUDSON WI 54016 (715) 381-1416 SARAH SCHEERINGA County: ST CROIX BURKWOOD TREATMENT CENTER (0012365) 615 OLD MILL RD HUDSON WI 54016 (715) 386-6125 MARK LANCET County: ST CROIX COMFORTS OF HOME - HUDSON (0010987) 1111 HEGGEN HUDSON WI 54016 (715) 377-0660 KAREN MARKEY County: ST CROIX COMFORTS OF HOME BALDWIN (0009851) 1880 FOURTH AVE BALDWIN WI 54002 (715) 688-2750 MAURA SCHWAEGEL County: ST CROIX COMFORTS OF HOME HUDSON II (0014271) 805 HEGGEN ST HUDSON WI 54016 (715) 386-3324 KAREN MARKEY County: ST CROIX DEERFIELD (THE) (0008844) 1127 WEST EIGHTH STREET NEW RICHMOND WI 54017 (715) 243-3900 JOANN WRICH County: ST CROIX EXODUS HOUSE (0012273) 698 BAKER RD HUDSON WI 54016 (715) 386-3015 BRUCE CLENDENEN County: ST CROIX OUR HOUSE ASSISTED/MEMORY CARE (0013427) 1310 CIRCLE PINE DR NEW RICHMOND WI 54017 (715) 246-7655 LIZA PRUST County: ST CROIX PINE RIDGE ASSISTED LIVING (0012820) 1320 WISCONSIN ST HUDSON WI 54016 (715) 381-4200 DAN GOODIER County: ST CROIX RED CEDAR CANYON ASSISTED LIVING (0013526) 3001 HANLEY RD HUDSON WI 54016 (715) 381-7333 PATRICIA SHERLEY County: ST CROIX ALMOST HOME AGAIN LLC (0013267) N3531 ELDER DR GILMAN WI 54433 (715) 965-1686 ALEXANDRA ELLIS County: TAYLOR

AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 CRC WISCONSIN RD LLC D/B/A BURKWOOD (715) 386-6125 BURKWOOD TREATMENT CNTR 615 OLD MILL RD HUDSON WI 54016 HUDSON COH LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118 BALDWIN COH LLC (651) 287-0265 SCHILLINGER RHONDA 720 MAIN STREET STE 205 MENDOTA HEIGHTS MN 55118 HUDSON COH II LLC (651) 287-0265 RHONDA SCHILLINGER 720 MAIN ST STE 205 MENDOTA HEIGHTS MN 55118 (715) 243-3900 JOANN WRICH 1127 WEST EIGHTH STREET NEW RICHMOND WI 54017 LUTHERAN SOC SERV OF WI & UPPER MI INC (715) 552-2400 LAURIE LESSARD 3136 CRAIG RD EAU CLAIRE WI 54701 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 CHRISTIAN COMMUNITY HOMES & SERVICES I (715) 381-4210 DAN GOODIER 1320 WISCONSIN ST HUDSON WI 54016 RED CEDAR CANYON ASSISTED LIVING LLC (651) 454-4801 PAT SHERLEY 3001 HANLEY RD HUDSON WI 54016 ALEXANDRA ELLIS (715) 447-5574 ALEXANDRA ELLIS N3531 ELDER DR GILMAN WI 54433

CBRF AA Gender - Capacity: M/F - 28 Low/High rate: 6,900/7,650 Initial License: 09/16/2008

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT

CBRF CNA Gender - Capacity: M/F - 41 Low/High rate: 3,900/4,700 Initial License: 07/07/2005

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,200/5,000 Initial License: 12/01/2002

Type: Class:

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 3,900/4,700 Initial License: 07/01/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 3,740/5,115 Initial License: 10/14/1999

Type: Class:

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,465/2,465 Initial License: 03/20/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,400/3,450 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 38 Low/High rate: 2,610/3,480 Initial License: 08/01/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 4,122/4,990 Initial License: 03/28/2011

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,300/3,410 Initial License: 06/07/2010

Type: Class:

CARE PARTNERS ASSISTED LIVING - MEDFORD (0013863) CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 955 E ALLMAN ST JASON LINDEMANN MEDFORD WI 54451 PO BOX 3006 (715) 748-2114 STINA DENK OSHKOSH WI 54903 County: TAYLOR

CBRF CNA Gender - Capacity: M/F - 18

Type: Class: Low/High rate:

Initial License:

09/08/2011

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 112

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,900/3,700 Initial License: 06/20/2006

Type: Class:

DEERVIEW MEADOWS MEDFORD (0011540) 509 LEMKE AVENUE MEDFORD WI 54451 (715) 748-5566 NANCY GOSSE County: TAYLOR

DEERVIEW MEADOWS ASSISTED LIVING LLC (608) 286-1231 WILLIAM/CHERYL TESNOW 1130 ARITA COURT #5 MADISON WI 53713

MEMORIAL NURSING & REHAB CENTER CBRF (610071) 135 SOUTH GIBSON STREET MEDFORD WI 54451 (715) 748-8100 SALLY SADOWSKA County: TAYLOR Association Approval: Leading Age OUR HOUSE ASSISTED CARE (0013429) 1014 W BROADWAY AVE MEDFORD WI 54451 (715) 748-2901 KATHERINE FUCHS County: TAYLOR AURORA RES ALTERNATIVES INC 094 (510355) 624 SOBOTTA ST ARCADIA WI 54612 (608) 323-7757 SUE HERTZ County: TREMPEALEAU CRYSTAL LAKE TERRACE (0013803) 208 ELM ST STRUM WI 54770 (715) 695-2611 MICHAEL RYAN County: TREMPEALEAU FAMILY CIRCLE (510123) 211 6TH AVE N PO BOX 187 STRUM WI 54770 (715) 695-3531 THERESA OLSON County: TREMPEALEAU FARNAM COMMUNITY LIVING CENTER (510103) 18425 DODGE ST WHITEHALL WI 54773 (715) 538-4518 LAURA ENGLESBY County: TREMPEALEAU Association Approval: Leading Age BOTHNE HOUSE (510360) 100 BOTHNE DRIVE COON VALLEY WI 54623 (608) 634-2982 CAROL BRYE County: VERNON CARING HOUSE (510334) 119 W COURT ST VIROQUA WI 54665 (608) 637-8496 DOROTHY KAUFMAN County: VERNON EDELWEISS (510336) RT 3 BOX 67 FIRE#E8001A VIROQUA WI 54665 (608) 637-7395 DOROTHY KAUFMAN County: VERNON FAIR HAVEN (0008858) 601 ARENA DRIVE VIROQUA WI 54665 (608) 637-8115 JANE/CAROL MEYER/BRYE County: VERNON

MEMORIAL HEALTH CENTER (715) 748-8100 SALLY SADOWSKA 135 SOUTH GIBSON STREET MEDFORD WI 54451 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 AURORA RESIDENTIAL ALTERNATIVES INC (715) 235-1839 HOLLY HAKES 406 TECHNOLOGY DR E STE B MENOMONIE WI 54751 JOHN HALBLEIB (715) 577-6524 MICHAEL RYAN 208 ELM STREET, PO BOX 9 STRUM WI 54770 (715) 695-3531 THERESA OLSON PO BOX 187 STRUM WI 54770 TREMPEALEAU COUNTY HEALTH CARE CENTE (715) 538-4312 LAURA ENGLESBY 18425 DODGE STREET WHITEHALL WI 54773 CAROL BRYE/JANE MEYER (608) 452-2010 CAROL BRYE 100 BOTHNE DR COON VALLEY WI 54623 B CARE CORPORATION (262) 275-6771 DOROTHY KAUFMANN P O BOX 409 FONTANA WI 53125 B CARE CORPORATION (262) 275-6771 DOROTHY KAUFMANN PO BOX 409 FONTANA WI 53125 JANE MEYER AND CAROL BRYE (608) 637-8115 JANE MEYER 601 ARENA DRIVE VIROQUA WI 54665

CBRF AS Gender - Capacity: M/F - 10 Low/High rate: 2,067/2,454 Initial License: 01/01/1981

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 21 Low/High rate: 2,950/3,150 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 2,731/7,720 Initial License: 02/06/1997

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,800/5,000 Initial License: 08/26/2011

Type: Class:

ADVANCED AGED

CBRF ANA Gender - Capacity: M - 16 Low/High rate: 869/1,500 Initial License: 06/15/1989

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 18 Low/High rate: 2,517/2,990 Initial License: 01/23/1980

Type: Class:

CBRF CS Gender - Capacity: M/F - 15 Low/High rate: 2,516/4,500 Initial License: 05/01/1997

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,954/6,083 Initial License: 04/17/1990

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,824/4,106 Initial License: 04/01/1995

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,351/3,750 Initial License: 01/11/2000

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 113

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 1,979/2,085 Initial License: 02/15/1996

Type: Class:

Specialty Programs

LAFARGE AREA SENIOR CONCERNS-BETHEL PARKSIDE ( BETHEL HOME & SERVICES INC (608) 637-2171 315 WEST ADAMS COURT DEBRA STOUT TEWALT LAFARGE WI 54639 614 SOUTH ROCK AVE (608) 625-2308 DEBRA TEWALT VIROQUA WI 54665 County: VERNON Association Approval: Leading Age MILESTONE SENIOR LIVING - MEMORY CARE (0014075) 504 SALSBERY HILLSBORO WI 54634 (608) 489-3930 BOBBI RICHARDSON County: VERNON NIGHTINGALE (0014101) 421 N BIRD ST LAFARGE WI 54639 SHELLEY HANSENBLAKE County: VERNON OLD TIMES (510339) 206 POLLY RUDE WAY WESTBY WI 54667 (608) 634-2737 JANE/CAROL MEYER/BRYE County: VERNON SHERRY HOUSE (THE) (510352) 440 EAST CENTER STREET READSTOWN WI 54652 (608) 629-5150 KEVIN L GROSS County: VERNON VERNON AREA REHAB CENTER INC CBRF (510340) 811 ROGERS ST VIROQUA WI 54665 (608) 637-2353 DEANNA FORTNEY County: VERNON VIOLA HOUSE (THE) (0008941) 509 S WAGONER ST VIOLA WI 54664-8506 (608) 627-1111 KEVIN L GROSS County: VERNON HOME IN THE NORTHWOODS (A) LLC (0014143) 717 INDIANA ST EAGLE RIVER WI 54521 (715) 337-2035 CATE WILSON County: VILAS INNCARE (0008982) 4288 MAPLE CIRCLE DR S PHELPS WI 54554 (715) 545-3144 County: VILAS MILESTONE SENIOR LIVING (0013614) 2332 RAILROAD ST HWY 45N EAGLE RIVER WI 54521 (715) 479-8018 NIKKI REED County: VILAS OUR HOME I (610100) 12440 WARPATH LANE MINOCQUA WI 54548 (715) 356-2911 PATRICIA KOENIG County: VILAS OUR HOME II (0009081) 12440 WARPATH LANE MINOCQUA WI 54548 (715) 356-2911 PATRICIA KOENIG County: VILAS MILESTONE SENIOR LIVING LLC (608) 489-3930 JULIE HEIL 1574 W BROADWAY MADISON WI 53713 REM WISCONSIN III INC (608) 276-9209 SHELLEY HANSEN-BLAKE 2005 W BELTLINE HWY STE 203 MADISON WI 53713 JANE MEYER/CAROL BRYE (608) 634-2737 JANE/CAROL MEYER/BRYE 206 POLLY RUDE WAY WESTBY WI 54667 ASSISTED CARE INC (608) 634-2169 VERNEL VESBACH S1028 NINETY METER DR WESTBY WI 54667 VERNON AREA REHAB CENTER INC (608) 637-3934 DAWN SIMONSON 1133 NELSON PARKWAY VIROQUA WI 54665 ASSISTED CARE INC (608) 634-2169 KEVIN L GROSS 509 S. WAGONER ST VIOLA WI 54664-8506 HOME IN THE NORTHWOODS (A) LLC (715) 337-2035 DIANNE HERR 717 INDIANA ST EAGLE RIVER WI 54521 INNCARE OF WISCONSIN LLC (608) 658-3233 GAYLE BUBLITZ 4288 MAPLE CIRCLE DR S PHELPS WI 54554 MILESTONE SENIOR LIVING LLC (608) 819-2200 JULIE HEIL 1574 W BROADWAY STE 200 MADISON WI 53713 K CARE INC (715) 356-2911 PATRICIA KOENIG 12440 WARPATH LANE MINOCQUA WI 54548 K CARE INC (715) 356-2911 PATRICIA KOENIG 12440 WARPATH LANE MINOCQUA WI 54548

ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,300/3,300 Initial License: 04/09/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 4,311/8,775 Initial License: 04/05/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,352/3,750 Initial License: 02/10/1992

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 3,770/4,030 Initial License: 12/16/1996

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,930/3,377 Initial License: 01/01/1985

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,640/4,030 Initial License: 02/03/2000

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,200/3,700 Initial License: 07/02/2012

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,200/3,000 Initial License: 04/13/2000

Type: Class:

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,200/3,400 Initial License: 02/03/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,520/4,069 Initial License: 06/17/1988

Type: Class:

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,520/5,053 Initial License: 06/20/2000

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 114

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,360/4,170 Initial License: 10/27/2000

Type: Class:

OUR HOME III (0009067) 2187 KATIES LANE MINOCQUA WI 54548 (715) 356-2911 PATRICIA KOENIG County: VILAS OUR HOME LAC DU FLAMBEAU (0010443) 2201 W BOLTON LAKE LN LAC DU FLAMBEAU WI 54538 (715) 588-9222 PATRICIA KOENIG County: VILAS OUR PLACE INC (0010204) 215 EAST DIVISION STREET EAGLE RIVER WI 54521 (715) 479-5142 LINDA BAUER County: VILAS ARTISAN LAKE GENEVA (THE) (0014428) 6722 HIGHWAY 50 EAST LAKE GENEVA WI 53147 (262) 248-2029 PAT DEBRUIN County: WALWORTH BOULEVARD MANOR (310316) 945 LAKE GENEVA BLVD LAKE GENEVA WI 53147 (262) 248-8195 ERIC KLUG County: WALWORTH BURR OAK MANOR INC (310321) 264 WALWORTH ST GENOA CITY WI 53128 (262) 279-9991 PAMELA PREDICK County: WALWORTH

K CARE INC (715) 356-2911 PATRICIA KOENIG 12440 WARPATH LANE MINOCQUA WI 54548 OUR HOME K CARE INC (715) 356-2911 PATRICIA KOENIG 12440 WARPATH LANE MINOCQUA WI 54548 OUR PLACE INC (715) 479-5142 LINDA BAUER P O BOX 524 EAGLE RIVER WI 54521 MOSAIC MANAGEMENT GROUP LLC (608) 221-8010 KRISTA MCCOOK 2822 WAUNONA WAY MADISON WI 53713 ERIC KLUG (262) 248-8195 ERIC KLUG 945 LAKE GENEVA BLVD LAKE GENEVA WI 53147 BURR OAK MANOR INC (262) 279-9991 PAMELA PREDICK PO BOX 304 DELAVAN WI 53115

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,501/4,501 Initial License: 01/05/2004

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,265/2,655 Initial License: 10/17/2003

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 42 Low/High rate: 1,944/5,000 Initial License: 12/01/2012

Type: Class:

Gender - Capacity:

CBRF CA M/F - 8 Low/High rate: 2,200/2,200 Initial License: 12/13/1982

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 2,000/6,200 Initial License: 07/01/1995

CASA MIA CARE CENTER (310324) BOX 292 W1043 ROSEWOOD RD PELL LAKE WI 53157 (262) 279-6505 RENEE BROWN County: WALWORTH COBBLESTONES (0013075) 4492 COBBLESTONES RD DELAVAN WI 53115 (262) 740-0111 NANCY SCHNEIDER County: WALWORTH

CASA MIA CARE CENTER INC (262) 279-6505 RENEE BROWN BOX 292 W1043 ROSEWOOD RD PELL LAKE WI 53157 BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

CBRF AS Gender - Capacity: M/F - 15 Low/High rate: 1,800/2,300 Initial License: 07/01/1982

Type: Class:

CBRF AS Gender - Capacity: M/F - 6 Low/High rate: 5,247/5,258 Initial License: 01/01/2010

Type: Class:

COUNTRY HOME (0013080) N8525 HWY H WHITEWATER WI 53190 (262) 495-4421 NANCY SCHNEIDER County: WALWORTH

BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

Gender - Capacity:

CBRF AS M/F - 6 Low/High rate: 4,820/4,988 Initial License: 01/01/2010

Type: Class:

FAIR VIEW (0013067) W5903 HWY 12 WHITEWATER WI 53190 (262) 495-8085 NANCY SCHNEIDER County: WALWORTH

BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 5,499/5,962 Initial License: 01/01/2010

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 115

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF ANA Gender - Capacity: M/F - 180 Low/High rate: 620/4,742 Initial License: 06/01/1980

Type: Class:

FAIRHAVEN (310378) 435 W STARIN RD WHITEWATER WI 53190-1125 (262) 473-2140 MR LYNN BINNIE County: WALWORTH Association Approval: Leading Age GLEN SUPPORTED LIVING (THE) (310476) 1281 W MAIN ST WHITEWATER WI 53190 (262) 473-9876 MARY ISAACS County: WALWORTH GOLDEN YEARS ASSISTED LIVING RESIDENCE (310402) 270 RIDGE RD WALWORTH WI 53184 (262) 275-6103 JEAN DUESTERBECK County: WALWORTH Association Approval: WALA HEARTHSTONE (310689) 426 W NORTH ST WHITEWATER WI 53190 (262) 473-2140 LYNN BINNIE County: WALWORTH Association Approval: Leading Age HIDDEN VIEW (0013069) N8425 HWY 89 WHITEWATER WI 53190 (262) 473-0492 NANCY SCHNEIDER County: WALWORTH

FAIRHAVEN CORPORATION (262) 473-2140 MR LYNN BINNIE 435 W STARIN RD WHITEWATER WI 53190-1125 LUTHERAN SOC SERV OF WI & UPPER MI INC (414) 281-4400 LORI SURA 1281 W MAIN ST WHITEWATER WI 53190 GOLDEN YEARS NURSING HOME INC (262) 275-6103 RICHARD AUSTIN 270 RIDGE RD WALWORTH WI 53184 FAIRHAVEN CORPORATION (262) 473-2140 LYNN BINNIE 435 STARIN RD WHITEWATER WI 53190 BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

ADVANCED AGED

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,625/5,900 Initial License: 03/01/1996

Type: Class:

CBRF CNA Gender - Capacity: M/F - 27 Low/High rate: 3,545/6,840 Initial License: 04/19/1993

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 5,381/7,843 Initial License: 02/02/1998

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,244/5,845 Initial License: 01/01/2010

Type: Class:

INSPIRATION MINISTRIES (310343) N2270 HWY 67 WALWORTH WI 53184 (262) 275-6131 ROBIN KNOLL County: WALWORTH Association Approval: Leading Age JADE HOUSE (310430) 1541 W WALWORTH AVE WHITEWATER WI 53190 (262) 473-4447 MARK SCHROEDER County: WALWORTH JUST LIKE HOME IV (0010103) W5140 HWY A ELKHORN WI 53121 (262) 742-4931 DAVID DEIHS County: WALWORTH KETTLE VIEW (0013068) N8603 DUFFIN RD WHITEWATER WI 53190 (262) 495-2676 NANCY SCHNEIDER County: WALWORTH KIMBERLY LANE CBRF (310437) 416 KIMBERLY LN ELKHORN WI 53121 (262) 723-8077 LUCY JACKSON County: WALWORTH KINDREDHEARTS OF ELKHORN (0010415) 450 E GENEVA ST ELKHORN WI 53121 (262) 723-8400 DEB TALLEY County: WALWORTH

CHRISTIAN LEAGUE FOR THE HANDICAPPED I (262) 275-6131 MICHELLE LUSSMYER PO BOX 948 WALWORTH WI 53184 PRODUCTIVE LIVING SYSTEMS INC (715) 831-3910 MARK SCHROEDER 806 E COMMERCIAL AVE WHITEWATER WI 53190 JUST LIKE HOME IV (262) 742-4930 DAVID DEIHS W5140 HWY A ELKHORN WI 53121 BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190 SONJA NOTTELSON (414) 378-3920 SONJA NOTTELSON 104 LAZY LAKE DR FALL RIVER WI 53932 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 DOUGLAS HENNIG 450 E GENEVA ST ELKHORN WI 53121

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 1,500/5,465 Initial License: 09/01/1986

Type: Class: Type: Class:

ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,320/4,320 Initial License: 02/07/1989 CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 1,800/4,700 Initial License: 09/24/2003

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 5,259/5,563 Initial License: 01/01/2010

Type: Class: Type: Class:

CBRF AS Gender - Capacity: M/F - 5 Low/High rate: 4,349/4,436 Initial License: 11/11/1991 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,715/4,350 Initial License: 10/24/2003

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 116

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 5 Low/High rate: 4,000/6,000 Initial License: 01/09/2003

Type: Class:

LAKESIDE WOODLAND HOME (0009855) W913 WASHINGTON AVE BURLINGTON WI 53105 (262) 248-0294 WENDY HATTERS County: WALWORTH LAURAS HOME (310450) 945 LAKE GENEVA BLVD LAKE GENEVA WI 53147 (262) 248-9798 MARC KLUG County: WALWORTH

WENDY HATTERS (262) 949-7411 WENDY HATTERS PO BOX 724 LAKE GENEVA WI 53147 LAURA'S HOME LLC (262) 903-2624 MARC KLUG 945 LAKE GENEVA BLVD LAKE GENEVA WI 53147

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 2,400/6,000 Initial License: 11/03/1990

Type: Class:

OUR HOUSE MEMORY CARE (0013384) 945 E CHICAGO ST WHITEWATER WI 53190 (262) 473-1011 TRISH STRAIT County: WALWORTH PINECREST (0013737) N3367 CTY TK NN LAKE GENEVA WI 53147 (262) 249-8900 SCOTT CHAPPELL County: WALWORTH PRAIRIE VILLAGE NORTH (0013077) 311 TURTLE CREEK DR DELAVAN WI 53115 (262) 728-7650 NANCY SCHNEIDER County: WALWORTH

KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 SCOTT CHAPPELL (414) 708-5407 SCOTT CHAPPELL 4719 KINGDOM CT RACINE WI 53402 BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,199/4,325 Initial License: 09/30/2010

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

CBRF ANA Gender - Capacity: M/F - 12 Low/High rate: 2,200/3,100 Initial License: 08/08/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,166/8,991 Initial License: 01/01/2010

Type: Class:

PRAIRIE VILLAGE SOUTH (0013078) 315 TURTLE CREEK DR DELAVAN WI 53115 (262) 728-2220 NANCY SCHNEIDER County: WALWORTH

BROTOLOC SOUTH INC (262) 472-0486 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,032/5,194 Initial License: 01/01/2010

Type: Class:

RICHMOND WAY (0013070) N6032 STATE HWY 89 DELAVAN WI 53115 (608) 883-6684 NANCY SCHNEIDER County: WALWORTH RIDGESTONE VILLAGE LTD (310698) 1025 S SECOND ST DELAVAN WI 53115 (262) 728-2848 CHRISTINA KIESEL County: WALWORTH

BROTOLOC SOUTH INC (262) 473-0480 NANCY SCHNEIDER 209 S TAFT ST WHITEWATER WI 53190 RIDGESTONE VILLAGE LTD (262) 728-2848 CHRISTINA KIESEL 1025 S SECOND ST DELAVAN WI 53115

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,136/5,247 Initial License: 01/01/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,200/3,550 Initial License: 07/01/1998

Type: Class:

ROSEWOOD MANOR LLC (0009613) 2220 BORG RD DELAVAN WI 53115 (262) 728-7673 PAMELA PREDICK County: WALWORTH

ROSEWOOD MANOR LLC (262) 728-7673 PAMELA PREDICK PO BOX 564 DELAVAN WI 53115

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,800/5,600 Initial License: 07/15/2002

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 117

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M - 5 Low/High rate: 1,000/2,650 Initial License: 12/11/1990

Type: Class:

RUNGES CBRF FOR DEVELOPMENTALLY DISABLED (31 W3705 LOVELAND RD ELKHORN WI 53121 (262) 723-2462 LARRY & PAMELA RUNGE County: WALWORTH SAPPHIRE HOUSE (0011610) W7332 STATE ROAD 12 WHITEWATER WI 53190 (262) 473-0626 MARK SCHROEDER County: WALWORTH SUNNYSIDE HOME (310561) 1 EASTOWN MANOR ELKHORN WI 53121 (262) 723-4175 YVONNE NEAULT County: WALWORTH VILLAGE GLEN OF GENEVA CROSSING (0009329) 723 S CURTIS ST LAKE GENEVA WI 53147 (262) 248-4558 LAURIE WATROUS County: WALWORTH VINTAGE ON THE PONDS (310575) N4901 DAM RD DELAVAN WI 53115 (262) 728-2171 VICKI ZWIEG County: WALWORTH WBF GENOA CITY RETIREMENT HOME (310579) 1201 CTY RD H GENOA CITY WI 53128 (262) 279-3211 DIANE SCHULTZ County: WALWORTH

LARRY & PAMELA RUNGE (262) 723-2462 LARRY & PAMELA RUNGE W3705 LOVELAND RD ELKHORN WI 53121 PRODUCTIVE LIVING SYSTEMS INC (715) 831-3910 MARK SCHROEDER 806 E COMMERCIAL AVE WHITEWATER WI 53190 SUNNYSIDE HOME INC (262) 723-4175 YVONNE NEAULT 1 EASTOWN MANOR ELKHORN WI 53121 LAKE GENEVA ASSISTED LIVING OPERATING C (608) 258-8289 ANDY KERWIN 201 TOWNLINE ROAD LAKE GENEVA WI 53147 SCOA INC (262) 728-2171 LEE ANN CALI N4901 DAM RD DELAVAN WI 53115 WBF GENOA CITY RETIREMENT HOME INC (262) 279-3211 DIANE SCHULTZ PO BOX 426 GENOA CITY WI 53128

Gender - Capacity:

CBRF AA M-8 Low/High rate: 5,566/5,566 Initial License: 10/11/2006

Type: Class:

ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF AS M/F - 10 Low/High rate: 2,200/2,600 Initial License: 02/01/1985

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 18 Low/High rate: 3,600/5,400 Initial License: 07/10/2001

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 70 Low/High rate: 2,700/5,700 Initial License: 10/11/1993 CBRF AS Gender - Capacity: M/F - 30 Low/High rate: 750/3,100 Initial License: 06/30/1981

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED PUBLIC FUNDING

WHISPERING WILLOWS (310585) W4517 WILLOW BEND RD ELKHORN WI 53121 (262) 723-7388 CONNIE PALMER County: WALWORTH AIN DAH ING INC (510341) 704 N RIVER ST SPOONER WI 54801 (715) 635-8720 FREDERICKA DECOTEAU County: WASHBURN CARE PARTNERS ASSISTED LIVING LLC (0009048) W7184 GREEN VALLEY RD SPOONER WI 54801 (715) 635-9211 GLORIA WIDIKER County: WASHBURN COUNTRY TERRACE - SPOONER (0011535) N4810 HILL DR SPOONER WI 54801 (715) 635-3908 GLORIA WIDIKER County: WASHBURN GLENVIEW SPECIAL CARE WING (0012418) 201 GLENVIEW LANE SHELL LAKE WI 54871 (715) 468-4255 SUSAN WEATHERS County: WASHBURN AUTUMN OAKS LLC (0010126) 227 E WASHINGTON ST SLINGER WI 53086 (262) 644-5926 JESSICA MAYS County: WASHINGTON

WHISPERING WILLOWS INC (262) 723-7388 CONNIE PALMER W4211 PALMER RD LAKE GENEVA WI 53147 AIN DAH ING INC (715) 468-2928 FREDERICKA DECOTEAU P O BOX 386 SHELL LAKE WI 54871-0386 CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON E LINDEMANN P O BOX 3006 OSHKOSH WI 54902 COUNTRY TERRACE OF WISCONSIN INC (920) 232-1672 JASON LINDEMANN P O BOX 3006 OSHKOSH WI 54903 TH INC (715) 468-4255 SUSAN WEATHERS 201 GLENVIEW LANE SHELL LAKE WI 54871 ANN B OAK (262) 297-1060 ANN OAK 4701 HILLCREST DR WEST BEND WI 53095

Gender - Capacity:

CBRF ANA M/F - 11 Low/High rate: 2,500/3,000 Initial License: 06/17/1991

Type: Class:

Gender - Capacity:

CBRF AA M/F - 15 Low/High rate: 0/0 Initial License: 04/01/1980

Type: Class:

ALCOHOL/DRUG DEPENDENT

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 1,945/3,645 Initial License: 06/01/2000

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED

Gender - Capacity:

CBRF CNA M/F - 18 Low/High rate: 2,810/3,850 Initial License: 07/14/2006

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 12 Low/High rate: 3,200/3,500 Initial License: 05/29/2008

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 30 Low/High rate: 2,600/4,000 Initial License: 07/03/2003

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 118

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 4,582/4,582 Initial License: 08/09/2005

Type: Class:

CALM HARBOR (0011095) 141 S 8TH AVE WEST BEND WI 53095 (262) 338-6070 PHIL HARPER County: WASHINGTON CARRIE LANE HOUSE (0013172) 1707 CARRIE LN WEST BEND WI 53095 (262) 353-3278 AMANDA LAHR County: WASHINGTON COLUMBUS HOUSE (0013271) 5096 VALLEY TRL WEST BEND WI 53095 (262) 677-2870 JODI RAKETTI County: WASHINGTON COUNTRYVIEW GROUP HOME (310723) N112 W12850 MEQUON RD GERMANTOWN WI 53022 (262) 512-1177 MIKE YELIN County: WASHINGTON

NOVA SERVICES (262) 338-8842 PHIL HARPER 702 ELM ST WEST BEND WI 53095 TOUCHSTONE LIVING CARE LLC (262) 412-4002 ROBERT TURNER 7945 31ST AVE KENOSHA WI 53142 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 446-4488 JEFF KAPHENGST 2835 GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 ZVIA SHAER (262) 243-5515 MIKE YELIN 2145 W HEMLOCK RD GLENDALE WI 53209

ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,950/7,300 Initial License: 03/04/2010

Type: Class:

CBRF AA Gender - Capacity: M/F - 5 Low/High rate: 5,282/5,282 Initial License: 07/12/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 4,300/4,800 Initial License: 09/21/1998

Type: Class:

DEERVIEW MEADOWS ASSISTED LIVING I (0011353) 109 LONE OAK LANE HARTFORD WI 53027 (262) 673-7028 ANDREA WENDORF County: WASHINGTON DEERVIEW MEADOWS ASSISTED LIVING II (0011354) 111 LONE OAK LA HARTFORD WI 53027 (262) 673-7022 ANDREA WENDORF County: WASHINGTON ELLENS HOME GERMANTOWN (0012364) N113 W16358 SYLVAN CIR GERMANTOWN WI 53022 (262) 250-6455 BONNIE SANFELIPPO County: WASHINGTON ELLENS HOME SOUTH (0014373) W150N11127 FOND DU LAC GERMANTOWN WI 53022 (414) 640-5715 BONNIE SANFELIPPO County: WASHINGTON

DEERVIEW MEADOWS HARTFORD LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT #5 MADISON WI 53713 DEERVIEW MEADOWS HARTFORD LLC (608) 286-1231 WILLIAM TESNOW 1130 ALRITA CT #5 MADISON WI 53713 ELLENS HOME OF GERMANTOWN LLC (414) 531-2672 BONNIE SANFELIPPO 4780 BIRCHWOOD TRL WEST BEND WI 53095 ELLENS HOME OF GERMANTOWN LLC (414) 531-2672 BONNIE SANFELIPPO 4780 BIRCHWOOD TRL WEST BEND WI 53095

CBRF CNA Gender - Capacity: M/F - 14 Low/High rate: 2,795/3,645 Initial License: 03/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,795/3,645 Initial License: 03/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,000/6,000 Initial License: 09/30/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 23 Low/High rate: 4,000/6,000 Initial License: 01/29/2013

Type: Class:

EMERALD RIDGE ASSISTED LIVING LLC (0013777) 1025 BELL AVE HARTFORD WI 53027 (262) 670-9477 AMANDA CHOE County: WASHINGTON EXODUS TRANSITIONAL CARE FACILITY (310376) 1421 FOND DU LAC AVE KEWASKUM WI 53040 (262) 626-4166 CRAIG BRUESEWITZ County: WASHINGTON

EMERALD RIDGE ASSISTED LIVING LLC (920) 574-3833 KATHERINE TEGEN 3232 N BALLARD RD STE 202 APPLETON WI 54911 EXODUS TRANSITIONAL CARE FAC INC (262) 626-4166 CRAIG BRUESEWITZ 1421 FOND DU LAC AVE KEWASKUM WI 53040

CBRF CNA Gender - Capacity: M/F - 19 Low/High rate: 3,465/5,000 Initial License: 02/08/2012

Type: Class:

CBRF AS Gender - Capacity: M - 20 Low/High rate: 2,250/2,250 Initial License: 06/01/1980

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 119

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 31 Low/High rate: 4,086/5,503 Initial License: 07/29/2009

Type: Class:

FIELDS OF WASHINGTON COUNTY THE (0012737) 531 E WASHINGTON ST WEST BEND WI 53095 (262) 365-6503 EDWARD SOMERS County: WASHINGTON Association Approval: Leading Age FRIENDSHIP HOUSE (0009046) 5595 COUNTY RD Z WEST BEND WI 53095 (262) 306-2120 JOANNE BODIEN County: WASHINGTON Association Approval: Leading Age GERMANTOWN HOME (0012454) W164 N10502 TIMBERLINE CT GERMANTOWN WI 53022 (262) 365-3606 ROBIN MCCAIGUE County: WASHINGTON HARVEST HOME MAGNOLIA HOUSE (0013953) 230 ARBOR POINT AVE WEST BEND WI 53095 (262) 338-9600 BETH PAHMEIER County: WASHINGTON HARVEST HOME MULBERRY HOUSE (0013954) 238 ARBOR POINT AVE WEST BEND WI 53095 (262) 338-9600 BETH PAHMEIER County: WASHINGTON HAWTHORN MANOR INC (310413) 321 HAWTHORN DR WEST BEND WI 53095 (262) 338-3266 ANITA BECKER County: WASHINGTON HICKORY HAUS AT HARVEST HOME SENIOR LIVING (001 330 ARBOR POINT AVE WEST BEND WI 53095 (920) 901-9482 BETH PAHMEIER County: WASHINGTON IVY MANOR OF JACKSON (0011475) W194 N16744 EAGLE DR JACKSON WI 53037 (262) 677-0651 SUSAN K POLSTER County: WASHINGTON IVY MANOR OF WEST BEND (0013787) 370 S FOREST AVE WEST BEND WI 53095 (262) 305-1209 SUSAN K POLSTER County: WASHINGTON IVY MANOR OF WEST BEND BLDG 2 (0014319) 350 S FOREST WEST BEND WI 53095 (262) 365-0056 SUSAN K POLSTER County: WASHINGTON KETTLE MORAINE GARDENS (0012055) 1038 FOND DU LAC AVE KEWASKUM WI 53040 (262) 626-4990 TINA THULL County: WASHINGTON

WASHINGTON COUNTY JESSICA TRAPP 531 E WASHINGTON ST WEST BEND WI 53095 BENEVOLENT CORPORATION CEDAR COMMUN (262) 306-2100 MICHELLE WALSH 5595 COUNTY RD Z WEST BEND WI 53095 GUARANTEED QUALITY LIVING OF WI LLC (262) 353-3144 ROBIN MCCAIGUE 2030 E WASHINGTON ST WEST BEND WI 53095 HARVEST HOME SENIOR LIVING SERVICES INC (920) 901-9482 BETH PAHMEIER 1007 N WISCONSIN DR HOWARDS GROVE WI 53083 HARVEST HOME SENIOR LIVING SERVICES INC (920) 901-9482 BETH PAHMEIER 1007 N WISCONSIN DR HOWARDS GROVE WI 53083 ANITA BECKER (262) 338-3266 ANITA BECKER 5743 DEBBIE LANE WEST BEND WI 53095 HARVEST HOME SENIOR LIVING SERVICES INC (920) 901-9482 BETH PAHMEIER 1007 N WISCONSIN DR HOWARDS GROVE WI 53083 SUSAN K POLSTER (262) 305-1209 SUSAN K POLSTER 129 ERIN CT WEST BEND WI 53095 SUSAN K POLSTER (262) 305-1209 SUSAN K POLSTER 129 ERIN CT WEST BEND WI 53095 SUSAN K POLSTER (262) 305-1209 SUSAN POLSTER 129 ERIN CT WEST BEND WI 53095 TINA THULL (262) 689-9725 TINA THULL 8735 HWY HH KEWASKUM WI 53040

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,040/4,680 Initial License: 10/16/2000

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 4,305/7,703 Initial License: 08/18/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,300/4,200 Initial License: 12/07/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,300/4,200 Initial License: 12/07/2011

Type: Class:

CBRF AS Gender - Capacity: M/F - 13 Low/High rate: 2,000/2,700 Initial License: 06/28/1989

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,895/4,495 Initial License: 06/13/2012

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 3,400/5,000 Initial License: 06/12/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 3,550/5,200 Initial License: 09/15/2011

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 26 Low/High rate: 3,660/4,100 Initial License: 09/24/2012

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 21 Low/High rate: 3,100/4,200 Initial License: 11/15/2007

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 120

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 4,150/5,950 Initial License: 11/15/2007

Type: Class:

KETTLE MORAINE GARDENS MEMORY UNIT (0012054) 1042 FOND DU LAC AVE KEWASKUM WI 53040 (262) 626-2775 TINA THULL County: WASHINGTON LANDMARK @ JACKSON CROSSINGS (THE) (310375) N168 W22022 MAIN ST JACKSON WI 53037 (262) 993-2838 AMY LLOYD County: WASHINGTON RIVER WAY PLACE LLC (0010782) 831 E WASHINGTON ST WEST BEND WI 53095 (262) 335-1992 JACQUELINE WILSON County: WASHINGTON SERENITY VILLA (0012822) 1650 AMERICAN EAGLE DR SLINGER WI 53086 (262) 689-6973 TRACY ERMER County: WASHINGTON SERENITY VILLA II (0013482) 1600 AMERICAN EAGLE DR SLINGER WI 53086 (262) 644-9204 TRACY L ERMER County: WASHINGTON TRI MANOR LTD (310570) 1937 N MAIN ST WEST BEND WI 53090 (262) 334-1509 TERRI KAISER County: WASHINGTON WELLINGTON PLACE OF HARTFORD (0012030) 615 HILLDALE DR HARTFORD WI 53027 (262) 673-3544 MONICA RAKOWSKI County: WASHINGTON

TINA THULL (262) 689-9725 TINA THULL 8735 HWY HH KEWASKUM WI 53040 COMMUNITY HOMES OF WI INC (262) 993-0755 AMY LLOYD N168 W22022 MAIN ST JACKSON WI 53037 RIVER WAY PLACE LLC (262) 335-1992 JACQUELINE WILSON 831 E WASHINGTON ST WEST BEND WI 53095 TRACY ERMER (262) 334-0092 TRACY ERMER 3015 NEWARK DR E WEST BEND WI 53090 TRACY L ERMER (262) 689-6973 TRACY L ERMER 1650 AMERICAN EAGLE DR SLINGER WI 53086 TRI MANOR LTD (920) 745-2370 RICHARD SCHULZ 504 WOODSIDE AVE RIPON WI 54971 WELLINGTON HOMES OF WISCONSIN LLC (703) 868-0503 MONICA RAKOWSKI 615 HILLDALE DR HARTFORD WI 53027

IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 4,400/5,400 Initial License: 05/25/1993

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 45 Low/High rate: 3,275/4,325 Initial License: 01/01/2005

Type: Class:

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 4,000/4,600 Initial License: 06/15/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 26 Low/High rate: 4,000/4,600 Initial License: 11/16/2010

Type: Class:

CBRF CS Gender - Capacity: M/F - 19 Low/High rate: 2,450/3,275 Initial License: 03/23/1984

Type: Class:

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 2,839/5,267 Initial License: 09/07/2007

Type: Class:

WEST BEND OPS LLC DBA LIGHTHOUSE OF WEST BEND ( WEST BEND OPS LLC (612) 817-4878 2130 CONTINENTAL DR SCOTT MCCUTCHEON WEST BEND WI 53095 4920 LINCOLN DR (262) 338-0092 DEAN BECKER EDINA MN 55436 County: WASHINGTON A LOVING HOME (310302) 21470 LEES CT BROOKFIELD WI 53045 (262) 827-0666 MOLLY MAGUIRE County: WAUKESHA ANDREW HOME (0009790) 909 OLD TOWER RD OCONOMOWOC WI 53066 (262) 569-6328 MARGUERITE RUPNOW County: WAUKESHA ANTHONY HOME (0009786) 1231 BLUE DAHLIA RD OCONOMOWOC WI 53066 (262) 569-5501 MARGUERITE RUPNOW County: WAUKESHA APPLEWOOD NEW BERLIN (310635) 2900 S MOORLAND RD NEW BERLIN WI 53151 (262) 784-2550 DEBORAH PETRAUSKI County: WAUKESHA A LOVING HOME INC (262) 827-0666 MAREL SORENSEN 21470 LEES CT BROOKFIELD WI 53045 PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW P O BOX 278 DOUSMAN WI 53118 PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 APPLEWOOD SENIOR LIVING INC (262) 784-2550 DEBORAH PETRAUSKI 2900 S MOORLAND RD NEW BERLIN WI 53151

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 4,000/6,700 Initial License: 10/20/2011

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 3,000/3,500 Initial License: 03/01/1996

Type: Class:

CBRF AA Gender - Capacity: F - 8 Low/High rate: 7,852/7,852 Initial License: 10/07/2002

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 7,657/7,657 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,800/4,400 Initial License: 12/23/1997

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 121

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 27 Low/High rate: 3,500/6,000 Initial License: 12/01/2010

Type: Class:

ARBOR VIEW COMMUNITIES OF PEWAUKEE (0013467) W232 N3471 HUNTERS RIDGE RD PEWAUKEE WI 53072 (262) 691-7400 BARBARA AUBREY County: WAUKESHA ARBORETUM V LLC (THE) CBRF (310670) W180 N7890 TOWN HALL RD MENOMONEE FALLS WI 53051 (262) 253-0909 MARY MILLIREN County: WAUKESHA AUSTIN HALL (0009717) 36100 GENESEE LAKE RD OCONOMOWOC WI 53066 (262) 569-5514 KERRI LESNIEWSKI County: WAUKESHA AUTUMN LIVING NORTH (0010951) 12850 12860 W EUCLID AVE NEW BERLIN WI 53151 (262) 785-0180 BRIAN SCHOENLEBER County: WAUKESHA AVALON SQUARE INC (0009325) 222 PARK PL WAUKESHA WI 53186 (262) 547-6741 KARI L AJACK County: WAUKESHA BIRCHROCK CORNERS (310611) 210 MCDIVITT LN MUKWONAGO WI 53149 (262) 363-9998 GARTH HARRIS County: WAUKESHA BRADFORD HOME (0012560) 644 BRADFORD WAY HARTLAND WI 53029 (262) 569-5515 MARGUERITE RUPNOW County: WAUKESHA BROOKDALE PLACE OF BROOKFIELD (0013589) 660 WOELFEL RD BROOKFIELD WI 53045 (262) 789-7499 ERICK NOWAK County: WAUKESHA CASEY HOUSE (0010138) 36100 GENESEE LAKE RD OCONOMOWOC WI 53066 (262) 569-5532 KERRI LESNIEWSKI County: WAUKESHA CCLS GARFIELD (0010780) 1306 GARFIELD AVE WAUKESHA WI 53186 (920) 261-1345 LUANNE BARNET County: WAUKESHA CCLS OAKDALE DRIVE (310328) 1606 OAKDALE DR WAUKESHA WI 53186 (262) 549-4348 RICHARD HINTZ County: WAUKESHA CCLS VICTORIA DRIVE (0009420) 1425 VICTORIA DR WAUKESHA WI 53186 (262) 549-9694 LUANNE BARNET County: WAUKESHA

ARBOR VIEW PEWAUKEE LLC (920) 960-4694 BARBARA AUBREY W232 N3471 HUNTERS RIDGE RD PEWAUKEE WI 53072 ARBORETUM V LLC (THE) (262) 548-5965 BETH ANDERSON 1805 KENSINGTON DR WAUKESHA WI 53188 OCONOMOWOC DEV TRNG CTR OF WIS LLC (262) 567-5515 RICHARD MAC NALLY 36100 GENESEE LAKE RD OCONOMOWOC WI 53066 AUTUMN LIVING INC (414) 315-9099 BRIAN SCHOENLEBER PO BOX 182 HALES CORNERS WI 53130 AVALON SQUARE INC (262) 547-6741 KARI L AJACK 222 PARK PL WAUKESHA WI 53186 BIRCHROCK CORNERS LLC (262) 363-9998 GARTH HARRIS 210 MCDIVITT LN MUKWONAGO WI 53149 PRADER-WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 BKD BROOKDALE PLACE OF BROOKFIELD, LLC (414) 918-5000 ERICK NOWAK 660 WOELFEL RD BROOKFIELD WI 53045 OCONOMOWOC DEV TRNG CTR OF WIS LLC (262) 569-5515 KIM RAY 36100 GENESEE LAKE RD OCONOMOWOC WI 53066 CCLS INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094

Gender - Capacity:

CBRF CNA M/F - 78 Low/High rate: 2,575/4,100 Initial License: 10/01/1990

Type: Class: Type: Class:

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 9,000/9,000 Initial License: 01/01/2002 CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,975/3,125 Initial License: 07/22/2005

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS DEVELOPMENTALLY DISABLED PUBLIC FUNDING

ADVANCED AGED DEVELOPMENTALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 27 Low/High rate: 3,736/6,477 Initial License: 12/14/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,709/4,200 Initial License: 12/05/1996

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 7,237/7,237 Initial License: 12/03/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 64 Low/High rate: 2,775/4,647 Initial License: 02/25/2011

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 9,399/9,399 Initial License: 02/09/2004

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED

Gender - Capacity:

CBRF AA M-8 Low/High rate: 2,661/2,661 Initial License: 01/26/2005

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,229/2,229 Initial License: 06/28/1991

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 2,750/2,750 Initial License: 09/25/2001

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 122

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,851/2,851 Initial License: 08/01/1984

Type: Class:

CCLS WELSH COURT (310329) 2704 2706 WELSH CT WAUKESHA WI 53188 (262) 547-6267 LUANNE BARNET County: WAUKESHA CENTURY HOUSE (0013580) 1130 NORTHVIEW RD WAUKESHA WI 53188 (262) 544-6233 ANTONIO DESHAZOR County: WAUKESHA CEPHAS HALFWAY HOUSE (0013468) 325 SENTINEL DRIVE WAUKESHA WI 53189 (262) 549-9449 CONNIE SCHRANK County: WAUKESHA CHATEAU LEBLANC GROUP HOME (310340) N27 W30818 GOLF HILLS DR PEWAUKEE WI 53072 (262) 369-6312 NICOLE SENTZ County: WAUKESHA CLA BUTLER (0010567) 12605 W COURTLAND AVE BUTLER WI 53007 (262) 373-0245 JOANNE ZUTZ County: WAUKESHA CLARE BRIDGE OF BROOKFIELD (310345) 15100 W CAPITOL DR BROOKFIELD WI 53005 (262) 781-5220 REBECCA ALABADO County: WAUKESHA CORY HOME (0012200) 201/203 CORY AVE DOUSMAN WI 53118 (262) 965-2050 KERRI LESNIEWSKI County: WAUKESHA COUNTRY CASTLE GROUP HOME (0012381) 21530 W LOCHLEVEN LN NEW BERLIN WI 53146 (262) 682-4068 KATHLEEN LIKNESS County: WAUKESHA CREATIVE LIVING ENVIRONMENTS - CLARION MANOR (0 21325 CLARION LN WAUKESHA WI 53186 (262) 798-1825 LAURIE HINTZ County: WAUKESHA

CREATIVE COMMUNITY LIVING SERVICES INC (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094 MATT TALBOT RECOVERY SERVICES, INC (262) 641-9050 KARL RAJANI PO BOX 20007 GREENFIELD WI 53220-0007 LUTHERAN SOCIAL SERVICES OF WI AND UPP (262) 896-3446 DEB ADAMUS 325 SENTINEL DRIVE WAUKESHA WI 53189 LEMAR HOMES INC (262) 369-6312 VICKI LEBLANC N27 W30818 GOLF HILLS DR PEWAUKEE WI 53072 COMMUNITY LIVING ARRANGEMENTS INC (262) 723-8392 JOANNE ZUTZ PO BOX 200 ELKHORN WI 53121 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 JANE LEUZINGER 15100 W CAPITOL DR BROOKFIELD WI 53005 OCONOMOWOC DEVELOPMENTAL TRAINING C (262) 569-5515 RICHARD MACNALLY PO BOX 278 DOUSMAN WI 53118 LIKNESS HOMES INC (262) 352-2836 KATHLEEN LIKNESS S67 W24465 SKYLINE AVENUE WAUKESHA WI 53188 CREATIVE LIVING ENVIRONMENTS (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,550/3,565 Initial License: 02/03/2011

Type: Class:

ALCOHOL/DRUG DEPENDENT

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,310/2,310 Initial License: 02/07/2011

Type: Class:

ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,700/6,000 Initial License: 05/10/1996

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 7 Low/High rate: 4,867/5,475 Initial License: 11/09/2005

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 24 Low/High rate: 3,975/3,975 Initial License: 10/30/1991

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 7,306/7,306 Initial License: 11/27/2007

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 3,300/3,565 Initial License: 05/17/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 2,500/3,125 Initial License: 10/01/2008

Type: Class:

CREATIVE LIVING ENVIRONMENTS RAINBOW TERRACE ( 15831 W SANTA ROSA BLVD NEW BERLIN WI 53151 (262) 782-5777 LAURIE HINTZ County: WAUKESHA

CREATIVE LIVING ENVIRONMENTS (920) 261-1345 LUANNE BARNET 314 E MAIN ST WATERTOWN WI 53094

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,500/3,125 Initial License: 10/01/2008

Type: Class:

CURTIS HALL (0009718) 36100 GENESEE LAKE RD OCONOMOWOC WI 53066 (262) 569-5536 KERRI LESNIEWSKI County: WAUKESHA

OCONOMOWOC DEV TRNG CTR OF WIS LLC (262) 569-5515 RICHARD MAC NALLY 36100 GENESEE LAKE RD OCONOMOWOC WI 53066

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 9,070/9,070 Initial License: 01/01/2002

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 123

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,200/3,500 Initial License: 01/23/2008

Type: Class:

D ILANA HOUSE (0012234) W274 S4025 TIMBER TRL WAUKESHA WI 53189 (262) 408-2102 STACY ENGLUND County: WAUKESHA

MILOUDI INC (262) 271-0993 SAM LAHRACHE W274 S4025 TIMBER TRL WAUKESHA WI 53189

FAIRVIEW ELM GROVE PLACE (310379) 260 S ELM GROVE RD BROOKFIELD WI 53005 (262) 789-7848 CINDY JOHNSON County: WAUKESHA FAIRVIEW HOUSE (0010004) 1820 WESTMOOR TERRACE ELM GROVE WI 53122 (262) 796-0123 CINDY JOHNSON County: WAUKESHA FOREST GROVE (310692) 13800 FOREST GROVE RD BROOKFIELD WI 53005 (262) 786-5900 CINDY JOHNSON County: WAUKESHA GATE HOUSE (0009716) 123 LAWN ST HARTLAND WI 53029 (262) 367-0644 JUDITH WOLTER County: WAUKESHA GOLDEN OAKS (0013446) 21600 W CLEVELAND AVE NEW BERLIN WI 53146 (262) 554-1189 CRYSTAL MILLER County: WAUKESHA

FAIRVIEW SENIOR HOMES INC (262) 786-5900 PAMELA RISCHE 890 ELM GROVE RD BLDG2 STE 107 ELM GROVE WI 53122 FAIRVIEW SENIOR HOMES INC (262) 786-5900 PAMELA RISCHE 890 ELM GROVE RD BLDG2 STE 107 ELM GROVE WI 53122 FAIRVIEW SENIOR HOMES INC (262) 786-5900 PAMELA RISCHE 890 ELM GROVE RD BLDG2 STE 107 ELM GROVE WI 53122 PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 FRONTIDA INC (262) 308-3839 CRYSTAL MILLER PO BOX 580254 PLEASANT PRAIRIE WI 53158

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 3,150/3,350 Initial License: 08/01/1995

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,750/4,150 Initial License: 03/17/2003

Type: Class:

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 3,450/3,850 Initial License: 04/30/1998

Type: Class:

CBRF AA Gender - Capacity: M/F - 16 Low/High rate: 8,788/8,788 Initial License: 01/01/2002

Type: Class:

CBRF AS Gender - Capacity: M/F - 16 Low/High rate: 3,000/3,600 Initial License: 09/22/2010

Type: Class:

HANSON HOUSE (0009739) 240 WOLF DRIVE DOUSMAN WI 53118 (262) 569-5515 MARGUERITE RUPNOW County: WAUKESHA HARTFEL HOUSE (310410) N88 W17630 CHRISTMAN RD MENOMONEE FALLS WI 53051 (262) 251-1265 BARBARA PRICE County: WAUKESHA HARTLAND TERRACE (0012378) 327B NORTH AVE HARTLAND WI 53029 (262) 369-4391 JENNIFER MCLEOD County: WAUKESHA HAWTHORNE COURT (0008888) 470 SCARLET HAWTHORNE CT BROOKFIELD WI 53045 (262) 798-1594 CINDY JOHNSON County: WAUKESHA HERITAGE AT DEER CREEK (CBRF) (0009763) 3585 S 147TH ST NEW BERLIN WI 53151 (262) 789-6600 LINDA KRAUSE County: WAUKESHA HERITAGE COURT (0010630) N48 W14250 HAMPTON AVE MENOMONEE FALLS WI 53051 (262) 781-6930 KATIE CORBETT County: WAUKESHA

PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW P O BOX 278 DOUSMAN WI 53118 STEP INC (262) 251-1265 BARBARA PRICE N88 W17630 CHRISTMAN RD MENOMONEE FALLS WI 53051 HARTLAND TERRACE II LLC (262) 424-0180 JENNIFER MCLEOD 327B NORTH AVE HARTLAND WI 53029 FAIRVIEW SENIOR HOMES INC (262) 786-5900 PAMELA RISCHE 890 ELM GROVE RD BLDG2 STE 107 ELM GROVE WI 53122 HERITAGE 2 LLC (952) 351-4540 CINDY PAULSON 3585 S 147TH ST NEW BERLIN WI 53151 HERITAGE ASSISTED LIVING (952) 351-4540 CINDY PAULSON 9701 W NATIONAL AVE WEST ALLIS WI 53214

CBRF CS Gender - Capacity: M/F - 14 Low/High rate: 7,852/7,852 Initial License: 10/24/2002

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED

CBRF AA Gender - Capacity: M - 8 Low/High rate: 2,030/2,171 Initial License: 05/01/1980

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 4,000/5,000 Initial License: 05/01/2008

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,150/4,120 Initial License: 11/24/1999

Type: Class:

CBRF CNA Gender - Capacity: M/F - 33 Low/High rate: 3,600/4,200 Initial License: 02/05/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 3,800/4,600 Initial License: 10/21/2004

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 124

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 3,494/3,494 Initial License: 03/18/2003

Type: Class:

HIL CANAAN (0009981) 443 FREEMAN ST WAUKESHA WI 53189 (262) 524-8467 SARAH RAUSCH County: WAUKESHA HIL CRESCENT HOUSE (0009791) W228 N4043 CRESCENT DR PEWAUKEE WI 53072 (262) 695-1105 DOROTHY LUMPKIN County: WAUKESHA HIL DEER HAVEN (0009962) N26 W26286 QUAIL HOLLOW RD PEWAUKEE WI 53072 (262) 695-7135 ANDREA PADRON County: WAUKESHA HIL FLEETFOOT (0013201) 1316/1318 FLEETFOOT DR WAUKESHA WI 53186 (262) 408-2811 SARAH RAUSCH County: WAUKESHA HIL GREENMEADOW (0012708) 204 GREENMEADOW DR WAUKESHA WI 53188 (262) 490-0234 DOROTHY LUMPKIN County: WAUKESHA HIL GREENWAY (0013083) 1329 GREENWAY TERRACE WAUKESHA WI 53186 (262) 408-2441 DOROTHY LUMPKIN County: WAUKESHA HIL HAWTHORNE HOUSE (0009796) N60 W15734 W HAWTHORNE DR MENOMONEE FALLS WI 53051 (262) 703-0544 DOROTHY LUMPKIN County: WAUKESHA HIL JORDAN HOUSE (0009759) 2165 LAURA LN WAUKESHA WI 53186 (262) 542-3431 MARYBETH VANDERMALE County: WAUKESHA HIL LAKEVIEW (0009811) 504 W WISCONSIN AVE PEWAUKEE WI 53072 (262) 691-4162 MARYBETH VANDERMALE County: WAUKESHA HIL ORCHARD KNOLL (0009797) 1500 NORTHVIEW RD WAUKESHA WI 53188 (262) 544-9783 ANDREA PADRON County: WAUKESHA HIL PEWAUKEE HOUSE (0009704) 303 OAKTON AVE PEWAUKEE WI 53072 (262) 691-3942 MARYBETH VANDERMALE County: WAUKESHA HIL SKYLINE HOUSE (0009690) 5265 S SKYLINE DR NEW BERLIN WI 53151 (414) 235-3359 SARAH RAUSCH County: WAUKESHA

HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5515 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 JEFF KAPHENGST PO BOX 278 DOUSMAN WI 53118 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 SANDI BEDNARSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WIS LLC (262) 569-5520 JEFF KAPHENGST 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072 HOMES FOR INDEPENDENT LIVING OF WI LLC (262) 569-5520 SANDI BEDNARDSKI 2835 N GRANDVIEW BLVD STE 150 PEWAUKEE WI 53072

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 5 Low/High rate: 5,509/5,509 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 5,143/5,143 Initial License: 03/01/2003

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,826/3,826 Initial License: 05/12/2010

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 5,292/5,292 Initial License: 03/23/2009

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 5,034/5,034 Initial License: 03/12/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,708/6,708 Initial License: 01/01/2002

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,818/3,818 Initial License: 01/01/2002

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,748/3,748 Initial License: 01/01/2002

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 5 Low/High rate: 4,874/4,874 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,748/3,748 Initial License: 01/01/2002

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,463/5,463 Initial License: 01/01/2002

Type: Class:

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 125

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 4,300/5,100 Initial License: 07/02/2010

Type: Class:

HILLSDALE HOUSE (0013303) 2310 HILLSDALE DRIVE EAST BROOKFIELD WI 53005 (262) 785-6208 LISA LIMJOCO County: WAUKESHA KIRKLAND CROSSINGS (0009361) 700 QUINLAN DR PEWAUKEE WI 53072 (262) 695-5800 JOHN CROSSWAITE County: WAUKESHA LAD LAKE COTTAGE UNIT (0011270) W350 S1401 WATERVILLE RD DOUSMAN WI 53118 (262) 965-2131 GARY L ERDMANN County: WAUKESHA LAD LAKE INC (0010164) W350 S1401 WATERVILLE RD DOUSMAN WI 53118 (262) 965-2131 JEFF PEASE County: WAUKESHA LANG HOME (0010990) 1234 NEWPORT DR OCONOMOWOC WI 53066 (262) 567-5835 JUDY WOLTER County: WAUKESHA LINDEN COURT MUKWONAGO (310452) 845 COUNTY RD NN EAST MUKWONAGO WI 53149 (262) 363-6830 HOLLY WISE County: WAUKESHA Association Approval: Leading Age LINDEN COURT WAUKESHA (0010827) 2330 W MICHIGAN AVE WAUKESHA WI 53188 (262) 524-6400 JONI SCHLAIS County: WAUKESHA Association Approval: Leading Age LSS GENESIS HALFWAY HOUSE (310399) 1002 MOTOR AVE WAUKESHA WI 53188 (262) 544-0711 JAMES AKER County: WAUKESHA LYNNWOOD OF DELAFIELD (0009711) W302 N1632 MAPLE AVE PEWAUKEE WI 53072 (262) 367-9677 HOLLY NYGRO County: WAUKESHA MAPLE ROAD GROUP HOME (0011662) W187 N8581 MAPLE ROAD MENOMONEE FALLS WI 53051 (262) 253-9827 JILL VAN CALSTER County: WAUKESHA MARION HOUSE (310472) 401 S PRAIRIE ST WAUKESHA WI 53186 (262) 547-0870 JENNIFER MICKOLICHEK County: WAUKESHA

KLF HOMES LLC (414) 243-2840 LISA LIMJOCO 13805 LLOYD ST ELM GROVE WI 53122 PRESBYTERIAN HOMES PARTNERS INC (262) 547-9217 JOHN CROSSWAITE 700 QUINLAN DR PEWAUKEE WI 53072 LAD LAKE INC (262) 965-2131 JEFF PEASE PO BOX 158 DOUSMAN WI 53118 LAD LAKE INC (262) 965-2131 JEFF PEASE PO BOX 158 DOUSMAN WI 53118 PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 LINDENGROVE INC (262) 797-4600 HOLLY WISE 845 COUNTY RD NN EAST MUKWONAGO WI 53149 LINDENGROVE INC (262) 797-4600 JONI SCHLAIS 2330 W MICHIGAN AVE WAUKESHA WI 53188 LUTHERAN SOC SERV OF WI & UPPER MI INC (262) 896-3446 JAMES AKER 1002 MOTOR AVENUE WAUKESHA WI 53188 HEALTHSPAN INC (414) 541-4700 LORI PAPROCKI 5520 W FOREST HOME AVE GREENFIELD WI 53220 CURATIVE CARE NETWORK (414) 479-9411 JILL VAN CALSTER 1000 N 92ND ST MILWAUKEE WI 53226 VOLUNTEERS OF AMERICA WISCONSIN (414) 847-1515 ANNE FOERSTER 1661 N WATER ST, SUITE 401 MILWAUKEE WI 53202

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,130/6,270 Initial License: 10/31/2001

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF AA Gender - Capacity: M - 16 Low/High rate: 9,678/9,678 Initial License: 07/10/2006

Type: Class:

CBRF AA Gender - Capacity: M - 6 Low/High rate: 9,704/9,704 Initial License: 08/18/2003

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 7,852/7,852 Initial License: 08/02/2005

Type: Class:

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 4,350/5,150 Initial License: 09/23/1996

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 24 Low/High rate: 4,785/5,160 Initial License: 03/16/2005

Type: Class:

IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF AA Gender - Capacity: M - 12 Low/High rate: 2,494/2,494 Initial License: 03/01/1980

Type: Class:

ALCOHOL/DRUG DEPENDENT PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 4,200/5,500 Initial License: 04/07/2003

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 3,501/11,870 Initial License: 11/01/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,079/3,440 Initial License: 04/30/1982

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 126

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,270/6,014 Initial License: 06/15/2012

Type: Class:

MATTHEWS OF PEWAUKEE CBRF (0014154) 1109 CECELIA DR PEWAUKEE WI 53072-2524 (262) 695-6413 LESLIE FRITSCHE County: WAUKESHA

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

MERRILL HILLS MANOR (0013032) 3217 FIDDLERS CREEK DR WAUKESHA WI 53188 (262) 896-8888 RICHARD DOSS County: WAUKESHA MUSKEGO (0013081) S68 W12699 BRISTLECONE LANE MUSKEGO WI 53150 (414) 525-0307 ALEX KOLDEWAY County: WAUKESHA MUSKEGO NURSING HOME (310477) S77 W18690 JANESVILLE RD MUSKEGO WI 53150 (262) 679-0246 HAROLD SWANTO County: WAUKESHA NEW PERSPECTIVES BROOKFIELD 1 (0011457) 16720 W GREENFIELD AVE BROOKFIELD WI 53005 (262) 827-9017 ROBIN BALDWIN County: WAUKESHA NEW PERSPECTIVES BROOKFIELD 2 (0011458) 16690 W GREENFIELD AVE BROOKFIELD WI 53005 (262) 821-1180 ROBIN BALDWIN County: WAUKESHA NORTHFIELD MANOR (0011923) W128 N6900 NORTHFIELD DR MENOMONEE FALLS WI 53051 (262) 532-0800 MICHELE CARLSON County: WAUKESHA OAK HILL TERRACE V LLC (310668) 1805 KENSINGTON DR WAUKESHA WI 53188 (262) 548-1457 ROBERT BEST County: WAUKESHA RIVERLINE HOME (0014460) 1314 N RIVERLINE DR OCONOMOWOC WI 53066 (262) 468-5085 MARGUERITE RUPNOW County: WAUKESHA RIVERSIDE LODGE (310510) 410 N MAIN ST DOUSMAN WI 53118 (262) 965-7397 JOEL LAMMERS County: WAUKESHA Association Approval: Leading Age RIVERVIEW VILLAGE (0009599) W176 N9430 RIVER CREST DR MENOMONEE FALLS WI 53051 (262) 255-2557 LISA BENFIELD County: WAUKESHA

WAUKESHA - CRL SERVICES LLC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVE SUITE 3740 CHICAGO IL 60611 BROTOLOC SOUTH INC (262) 473-0480 SUSAN MILLARD 209 S TAFT ST WHITEWATER WI 53190 MUSKEGO NURSING HOME INC (262) 679-0246 HAROLD SWANTO S77 W18690 JANESVILLE RD MUSKEGO WI 53150 NEW PERSPECTIVE FUND 1, LLC (952) 746-3630 ROBIN BALDWIN 16690 W GREENFIELD AVE BROOKFIELD WI 53005 NEW PERSPECTIVES FUND 1, LLC (952) 746-3630 ROBIN BALDWIN 16690 W GREENFIELD AVE BROOKFIELD WI 53005 NORTHFIELD CRL LLC (847) 509-8636 DOUGLAS CAMERON 875 N MICHIGAN AVE SUITE 3740 CHICAGO IL 60611 OAK HILL TERRACE V LLC (262) 548-5965 BETH ANDERSON 1805 KENSINGTON DR WAUKESHA WI 53188 PRADER WILLI HOMES OF OCONOMOWOC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53066 WISCONSIN MASONIC HOME INC (262) 965-7397 DONNA PARKER 410 N MAIN ST DOUSMAN WI 53118 RIVERVIEW VILLAGE LLC (262) 255-3606 DEE K THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051

CBRF CNA Gender - Capacity: M/F - 97 Low/High rate: 2,700/5,300 Initial License: 11/20/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,069/6,375 Initial License: 01/01/2010

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 17 Low/High rate: 4,000/4,500 Initial License: 12/01/1979

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 4,245/4,675 Initial License: 11/02/2006 CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 4,400/5,150 Initial License: 11/02/2006

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 50 Low/High rate: 3,945/4,439 Initial License: 05/25/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 128 Low/High rate: 1,710/4,830 Initial License: 10/13/1986

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 8,295/8,295 Initial License: 01/24/2013

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,432/6,007 Initial License: 11/14/1995

Type: Class: Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 48 Low/High rate: 2,701/4,700 Initial License: 05/20/2002

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 127

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

CBRF AA Gender - Capacity: M/F - 20 Low/High rate: 15,660/15,660 Initial License: 09/28/2009

Type: Class:

Specialty Programs

ROGERS MEM HOSP HERRINGTON RECOVERY CENTER ( ROGERS MEMORIAL HOSPITAL (262) 646-4411 34700 VALLEY RD JOEL FEIST OCONOMOWOC WI 53066 34700 VALLEY RD (262) 646-4411 JOEL FEIST OCONOMOWOC WI 53066 County: WAUKESHA ROGERS MEM HOSP TURTLE POND RECOVERY CENTER (ROGERS MEMORIAL HOSPITAL INC (800) 767-4411 34700 VALLEY RD JOEL FEIST OCONOMOWOC WI 53066 34700 VALLEY RD (262) 646-4411 DAVID MOULTHROP OCONOMOWOC WI 53066 County: WAUKESHA ROGERS MEMORIAL HOSPITAL DELAFIELD A (0012062) W277 OAKWOOD DR DELAFIELD WI 53018 (262) 646-4411 JOEL FEIST County: WAUKESHA ROGERS MEMORIAL HOSPITAL DELAFIELD B (0012061) W325 OAKWOOD DR DELAFIELD WI 53018 (262) 646-4411 JOEL FEIST County: WAUKESHA SAMSON HOUSE (0013581) 611 N GRAND AVE WAUKESHA WI 53186 (262) 542-8118 ANTONIO DESHAZOR County: WAUKESHA SHOREHAVEN MEMORY CARE (0013899) 1305 W WISCONSIN AVE OCONOMOWOC WI 53066 (262) 567-8341 LORNA GARTZKE County: WAUKESHA Association Approval: Leading Age SKY RESIDENTIAL BROOKSIDE (0009132) 2405 S BROOKSIDE PKWY NEW BERLIN WI 53151-2905 (262) 821-1406 KIM NGUYEN County: WAUKESHA ROGERS MEMORIAL HOSPITAL (262) 646-4411 JOEL FEIST 34700 VALLEY RD OCONOMOWOC WI 53066 ROGERS MEMORIAL HOSPITAL (262) 646-4411 JOEL FEIST 34700 VALLEY RD OCONOMOWOC WI 53066 MATT TALBOT RECOVERY SERVICES, INC (262) 641-9050 KARL RAJANI PO BOX 20007 GREENFIELD WI 53220-0007 LUTHERAN HOMES OF OCONOMOWOC (262) 567-8341 LORNA GARTZKE 1305 W WISCONSIN AVE OCONOMOWOC WI 53066 SKY RESIDENTIAL SERVICES INC (414) 916-2710 KIM NGUYEN N94 W20846 SCHLEI RD MENOMONEE FALLS WI 53051

ALCOHOL/DRUG DEPENDENT

CBRF AA Gender - Capacity: M/F - 33 Low/High rate: 27,580/27,580 Initial License: 11/10/1997

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 25,080/25,080 Initial License: 02/08/2008

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF AA Gender - Capacity: M/F - 16 Low/High rate: 25,080/25,080 Initial License: 02/08/2008

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,572/2,658 Initial License: 02/03/2011

Type: Class:

EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 15 Low/High rate: 5,000/5,800 Initial License: 03/01/2012

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,850/7,750 Initial License: 11/02/2000

Type: Class:

ST COLETTA OF WI HYDRITE (0013998) 2309 RUSTIC WOODS CT WAUKESHA WI 53188 (262) 408-2131 ELIZABETH BRZESKI County: WAUKESHA ST COLETTA OF WI NORRIS (0013999) 405 PRAIRIE SONG DR WAUKESHA WI 53188 (262) 408-2170 ELIZABETH BRZESKI County: WAUKESHA STEPPING STONE (0010475) 700-702 HICKORY CREEK DR OCONOMOWOC WI 53066 (262) 569-4822 MARGUERITE RUPNOW County: WAUKESHA STERLING HOUSE OF SUSSEX (310682) W240 N6351 MAPLE AVE SUSSEX WI 53089 (262) 820-0330 TRAVIS BORCHERT County: WAUKESHA

ST COLETTA OF WISCONSIN (920) 674-4330 ANTHONY LODUCA N4637 COUNTY ROAD Y JEFFERSON WI 53549 ST COLETTA OF WISCONSIN (920) 674-4330 ANTHONY LODUCA N4637 COUNTY ROAD Y JEFFERSON WI 53549 PRADER WILLI HOMES OF OCONOMOWOC LLC (262) 569-5515 MARGUERITE RUPNOW PO BOX 278 DOUSMAN WI 53118 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 TRAVIS BORCHERT W240 N6351 MAPLE AVE SUSSEX WI 53089

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,007/3,739 Initial License: 02/24/2012

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,007/4,696 Initial License: 02/20/2012

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 7,945/7,945 Initial License: 04/19/2004

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,200/7,500 Initial License: 11/10/1997

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 128

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 4,108/4,650 Initial License: 09/21/2006

Type: Class:

SUMMIT HOUSE (0011511) 910 SUMMIT AVE WAUKESHA WI 53188 (262) 832-0134 KARA GLEASON County: WAUKESHA TUDOR OAKS WINDSOR GARDENS (0013745) S77 W12929 MCSHANE DR MUSKEGO WI 53150 (414) 529-0100 CHUCK LAMSON County: WAUKESHA TWIN OAKS (0013851) N4 W31511 TWIN OAKS DRIVE DELAFIELD WI 53018 (262) 646-4146 CRYSTAL MILLER County: WAUKESHA VICTORIAN CASTLE (0011711) 19700 W CLEVELAND AVE NEW BERLIN WI 53146 (262) 549-3130 KRISTOPHER KIEFER County: WAUKESHA

VOLUNTEERS OF AMERICA WISCONSIN (414) 847-1515 ANNE FOERSTER 1661 N WATER ST STE 401 MILWAUKEE WI 53202 AMERICAN BAPTIST HOMES OF THE MIDWEST (800) 536-3175 CHUCK LAMSON S77 W12929 MCSHANE DR MUSKEGO WI 53150 TWIN OAKS FRONTIDA INC (262) 925-9302 CRYSTAL MILLER PO BOX 580254 PLEASANT PRAIRIE WI 53158 CASTLE HOME CARE INC (414) 427-1655 KRISTOPHER KIEFER 10521 W LAYTON AVE STE 201 GREENFIELD WI 53228

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 5,665/6,056 Initial License: 08/08/2011

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,500/6,000 Initial License: 09/22/2011

Type: Class:

Gender - Capacity:

CBRF CS M/F - 8 Low/High rate: 3,618/4,500 Initial License: 01/03/2007

Type: Class:

VISTA POINTE (0014272) W180 N8200 TOWN HALL RD MENOMONEE FALLS WI 53051 (262) 689-1711 JILL GEIDEL County: WAUKESHA BEACON HOUSE (0013395) 307 W COOK ST NEW LONDON WI 54961 (920) 982-7352 NANCY COLLIER County: WAUPACA GARDEN PARK HOUSE (410133) 109 WEST LAKE STREET WAUPACA WI 54981 (715) 258-2191 CYNTHIA OERTER County: WAUPACA KINDREDHEARTS CLINTONVILLE (0009720) 76 GREEN TREE ROAD CLINTONVILLE WI 54929 (715) 823-7300 SANDY KRUEGER County: WAUPACA KINDREDHEARTS NEW LONDON (0009724) 1706 TAUBEL ROAD NEW LONDON WI 54961 (920) 982-0686 JEANETTE EGGERS County: WAUPACA MCKINLEY HOUSE (0013397) 75 N PARK ST CLINTONVILLE WI 54927 (715) 823-3032 NANCY COLLIER County: WAUPACA RAWHIDE ABC HOME (0009096) E7475 RAWHIDE ROAD NEW LONDON WI 54961 (920) 982-6100 CHRIS PRUITT County: WAUPACA STRONG HAVEN (0009441) N3501 HWY 110 WEYAUWEGA WI 54983 (920) 867-2801 MARIE SCHRAMM County: WAUPACA

ALISAN LLC (262) 689-1711 JILL GEIDEL 5595 HILLDALE DR SLINGER WI 53086 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 PRO HEALTH CONSUL INC (715) 258-2191 CYNTHIA OERTER 109 WEST LAKE STREET WAUPACA WI 54981 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 SANDY KRUEGER 76 GREEN TREE ROAD CLINTONVILLE WI 54929 PARTNERS IN COMMUNITY ELDERCARE LLC (608) 442-8005 JEANETTE EGGERS 1706 TAUBEL ROAD NEW LONDON WI 54961 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 RAWHIDE INC (920) 982-6100 DANIEL STONE E7475 RAWHIDE ROAD NEW LONDON WI 54961 (920) 867-2801 MARIE SCHRAMM N3501 HWY 110 WEYAUWEGA WI 54983

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 4,500/5,100 Initial License: 08/15/2012

Type: Class:

Gender - Capacity:

CBRF AA M/F - 8 Low/High rate: 3,621/5,170 Initial License: 08/01/2010

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF CS M/F - 12 Low/High rate: 2,100/2,900 Initial License: 03/14/1994

Type: Class:

ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,890/3,220 Initial License: 10/02/2002

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 19 Low/High rate: 2,905/3,235 Initial License: 10/02/2002

Type: Class:

ADVANCED AGED PUBLIC FUNDING

Gender - Capacity:

CBRF CNA M/F - 8 Low/High rate: 4,089/5,745 Initial License: 08/01/2010

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Gender - Capacity:

CBRF AA M-6 Low/High rate: 8,943/8,943 Initial License: 06/01/2001

Type: Class:

CORRECTIONAL CLIENTS

Gender - Capacity:

CBRF CS M/F - 7 Low/High rate: 2,714/3,714 Initial License: 09/20/2001

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 129

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 3,000/3,340 Initial License: 10/01/1995

Type: Class:

TRINITY TERRACE (410429) 1835 DIVISION STREET NEW LONDON WI 54961 (920) 982-9354 ROBERT FIETSCH County: WAUPACA Association Approval: Leading Age WAUPACA ELDER CARE HOME (410401) 510 RIVER STREET WAUPACA WI 54981 (715) 258-9681 KATHLEEN MILLER County: WAUPACA WHISTLING PINES INC (0012366) 121 CTY HWY QQ WAUPACA WI 54981 (715) 256-9193 CINDY WEISENSEL County: WAUPACA

ST JOSEPH RESIDENCE INC (920) 982-5354 ROBERT FIETSCH 1835 DIVISION STREET NEW LONDON WI 54961 MILLER ELDER CARE LLC (715) 258-9681 KATHLEEN MILLER 510 RIVER STREET WAUPACA WI 54981 JIM/LORENDA ROSIN (920) 229-3664 JIM ROSIN PO BOX 506 SPARTA WI 54565

ADVANCED AGED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 3,300/5,580 Initial License: 05/01/1995

Type: Class:

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 3,250/4,200 Initial License: 04/14/2008

Type: Class:

ARBOR PINES INC (0012367) 540 W PRAIRIE STREET WAUTOMA WI 54982 (920) 787-4466 CINDY WEISENSEL County: WAUSHARA

JIM/LARENDA ROSIN (920) 229-3664 JIM ROSIN PO BOX 506 SPARTA WI 54565

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,200/3,800 Initial License: 04/10/2008

Type: Class:

HEARTLAND HOUSE CBRF (0014477) 668 W CUMMINGS RD WAUTOMA WI 54982 (920) 787-1509 JOSIAH GROTHE County: WAUSHARA PRESTON PLACE CBRF (0014488) 401 PRESTON LN REDGRANITE WI 54970 (920) 566-0270 DOROTHY SCHULTZ County: WAUSHARA ROSEMORE VILLAGE (0010927) 830 HIGH ST WILD ROSE WI 54984 (920) 622-4141 SHARON MAREK County: WAUSHARA SILVER LAKE HAVEN (0012405) N2641 17TH LANE WAUTOMA WI 54982 (920) 787-7141 LINDA ZIMMERMAN County: WAUSHARA SILVER LAKE MANOR CBRF (0012406) N2641 17TH LANE WAUTOMA WI 54982 (920) 787-7141 LINDA ZIMMERMAN County: WAUSHARA TOWNLINE ROAD RESIDENCE (410059) 130 S TOWNLINE RD WAUTOMA WI 54982 (920) 787-3774 COLLEEN KASUBASKI County: WAUSHARA WAUTOMA HOUSE (THE) (0010450) 402 E DIVISION ST WAUTOMA WI 54982 (920) 787-4354 DAWN OLSON County: WAUSHARA

HEARTLAND HOUSE INC (920) 787-5817 JOSIAH GROTHE 668 W CUMMINGS RD WAUTOMA WI 54982 PRESTON PLACE INC (920) 566-0790 SETH HOLTE 401 PRESTON LN REDGRANITE WI 54970 ROSEMORE VILLAGE LLC (920) 622-4141 SHARON MAREK 830 HIGH ST WILD ROSE WI 54984 SILVER LAKE MANOR LLC (920) 787-7141 RICHARD GOHLKE N2641 17TH LANE WAUTOMA WI 54982 SILVER LAKE MANOR LLC (920) 787-7141 RICHARD GOHLKE N2641 17TH LANE WAUTOMA WI 54982 LIVING ENVIRONMENTAL FOUNDATION INC (920) 787-3774 COLLEEN KASUBASKI PO BOX 638 WAUTOMA WI 54982 CEREBRAL PALSY OF MIDEAST WISCONSIN IN (920) 424-4071 LORRAINE YARBROUGH PO BOX 1241 OSHKOSH WI 54903-1241

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,300/3,800 Initial License: 01/17/2013

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,300/4,000 Initial License: 01/17/2013

Type: Class:

CBRF CNA Gender - Capacity: M/F - 30 Low/High rate: 1,600/3,300 Initial License: 01/13/2006

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,600/3,000 Initial License: 06/03/2008

Type: Class:

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 1,600/3,000 Initial License: 07/01/2008

Type: Class:

CBRF AS Gender - Capacity: M/F - 8 Low/High rate: 2,471/2,803 Initial License: 04/01/1988

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,542/5,703 Initial License: 01/28/2004

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 130

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 16 Low/High rate: 2,910/4,991 Initial License: 06/15/2012

Type: Class:

ADARE I (0014163) 1645 CENTURY OAKS CT MENASHA WI 54952 (920) 915-8793 JENNIFER VANDENBOOGARD County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

ADARE II (0014164) 1650 CENTURY OAKS CT MENASHA WI 54952 (920) 915-8793 JENNIFER VANDENBOOGARD County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,910/4,991 Initial License: 06/15/2012

Type: Class:

ADARE III (0014165) 1665 CENTURY OAKS CT MENASHA WI 54952 (920) 915-8793 JENNIFER VANDENBOOGARD County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (313) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,910/4,991 Initial License: 06/15/2012

Type: Class:

ADARE IV (0014166) 1670 CENTURY OAKS CT MENASHA WI 54952 (920) 915-8793 JENNIFER VANDENBOOGARD County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,910/4,991 Initial License: 06/15/2012

Type: Class:

ALTEN HAUS TRADITIONS (0013951) 1091 JACOBSEN RD NEENAH WI 54956 (920) 470-9040 ANNE ALTENHOFEN KRAUSE County: WINNEBAGO ANEW CHOICE CARE INC I (0009557) 1255 DEPERE ST MENASHA WI 54952 (920) 722-4165 JASON SCHMITZ County: WINNEBAGO

ALTEN HAUS LLC (920) 470-9040 ANNE KRAUSE 4640 GRAND MEADOWS APPLETON WI 54914 ANEW CHOICE CARE INC (920) 419-2490 JASON SCHMITZ 1531 ELK TRAIL CT NEENAH WI 54956

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 3,500/4,500 Initial License: 01/27/2012

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,500/3,900 Initial License: 03/15/2002

ANEW CHOICE CARE INC II (0009558) 1265 DEPERE ST MENASHA WI 54952 (920) 722-4275 JASON SCHMITZ County: WINNEBAGO

ANEW CHOICE CARE INC (920) 419-2490 JASON SCHMITZ 1531 ELK TRAIL CT NEENAH WI 54956

Gender - Capacity:

CBRF CNA M/F - 6 Low/High rate: 3,500/3,900 Initial License: 03/15/2002

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 131

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 39 Low/High rate: 2,400/3,700 Initial License: 11/15/1992

Type: Class:

ARBORVIEW MANOR (410329) 1520 ARBORETUM DR OSHKOSH WI 54901-2790 (920) 231-7771 DIANN ROBERTS County: WINNEBAGO

NEW HAVEN INC (920) 231-7900 TIM BURNS PO BOX 851 OSHKOSH WI 54903-0851

BELLA VISTA MANOR (0012571) 631 HAZEL STREET OSHKOSH WI 54901 (920) 233-6667 DAWN MCPHERON County: WINNEBAGO

BELLA VISTA-CRL LLC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVENUE STE 3740 CHICAGO IL 60611

CBRF CNA Gender - Capacity: M/F - 36 Low/High rate: 2,500/3,500 Initial License: 11/03/2008

Type: Class:

CARE PARTNERS WINNECONNE I (0009034) 234 S 5TH ST WINNECONNE WI 54986 (920) 582-4662 SANDRA REESER County: WINNEBAGO

CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903

Gender - Capacity:

CBRF CNA M/F - 15 Low/High rate: 1,995/3,645 Initial License: 09/05/2000

Type: Class:

CARE PARTNERS WINNECONNE II (0009036) 524 GRANT ST WINNECONNE WI 54986 (920) 582-7977 CARRIE LUBEJKO County: WINNEBAGO

CARE PARTNERS ASSISTED LIVING LLC (920) 232-1672 JASON LINDEMANN PO BOX 3006 OSHKOSH WI 54903

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 1,945/3,645 Initial License: 07/01/2000

Type: Class:

CENTENNIAL INN (0009443) 1628 N MAIN ST OSHKOSH WI 54901 (920) 236-9360 DAWN MCPHERON County: WINNEBAGO

COMMUNITY RETIREMENT LIVING LLC (312) 794-8400 DOUGLAS CAMERON 875 N MICHIGAN AVENUE STE 3740 CHICAGO IL 60611-1916

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 2,831/3,600 Initial License: 10/05/2001

Type: Class:

CENTURY OAKS HOUSE 2 (0013952) 1110 W MURDOCK AVE OSHKOSH WI 54901 (920) 385-0570 KATTIE LEE County: WINNEBAGO

CENTURY OAKS INC (920) 915-1076 PAUL D MORAN 2748 HOLIDAY CT NEENAH WI 54956

CBRF CNA Gender - Capacity: M/F - 32 Low/High rate: 3,600/6,000 Initial License: 12/05/2011

Type: Class:

CENTURY OAKS RES CARE COMM INC SONIA MARIE (00 1018 W MURDOCK ST OSHKOSH WI 54902 (920) 475-7555 SHANNON MORAN County: WINNEBAGO

CENTURY OAKS HOMES (920) 915-1076 PAUL MORAN 2748 HOLIDAY CT NEENAH WI 54957

CBRF CNA Gender - Capacity: M/F - 28 Low/High rate: 3,400/4,500 Initial License: 06/10/2010

Type: Class:

CLARITY CARE BOWEN STREET HOUSE (410063) 2910 BOWEN ST OSHKOSH WI 54901 (920) 235-1432 NANCY COLLIER County: WINNEBAGO

CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901

CBRF AA Gender - Capacity: M/F - 7 Low/High rate: 3,710/3,710 Initial License: 06/01/1987

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 132

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,224/6,224 Initial License: 02/01/1993

Type: Class:

CLARITY CARE GREENFIELD HOUSE (410332) 643 GREENFIELD ST NEENAH WI 54956 (920) 751-4817 CONNIE SHAW County: WINNEBAGO CLARITY CARE JEFFERSON HOUSE (0011509) 1631 JEFFERSON STREET OSHKOSH WI 54901 (920) 426-1381 JULIA GERLACH County: WINNEBAGO CLARITY CARE MARICOPA GROUP HOME (410076) 1380 MARICOPA DR OSHKOSH WI 54904 (920) 233-2031 CHRIS KATZKE County: WINNEBAGO CLARITY CARE PACKER HEIGHTS (0009823) 560 W PACKER AVE OSHKOSH WI 54901 (920) 966-1414 CATHY STEINKE County: WINNEBAGO CLARITY CARE STATE STREET HOUSE (410081) 105 STATE ST NEENAH WI 54956 (920) 722-7110 ANNE M LEACH County: WINNEBAGO CLARITY CARE THIRD STREET HOUSE (410083) 225 THIRD ST NEENAH WI 54956 (920) 725-9673 LISA PRELLWITZ County: WINNEBAGO CLARITY CARE WISCONSIN HEIGHTS (0010727) 550 W PACKER AVE OSHKOSH WI 54901 (920) 966-1278 VICKY JOHNSON County: WINNEBAGO CONGRESS (0013750) 1002 CONGRESS AVE WI 54901 (920) 426-3306 NICOLE GREETAN County: WINNEBAGO CORAL HOUSE (410521) 675 PLANEVIEW DR OSHKOSH WI 54904 (920) 688-3760 KIERSTEN KARLSEN County: WINNEBAGO DIVERSE OPTIONS INC BONNIEVIEW HOME (0008831) 6412 BONNIEVIEW RD PICKETT WI 54964 (920) 589-5014 DONNA HEIN County: WINNEBAGO EASTBROOKE MANOR ASSISTED LIVING & MEMORY (00 3504 W 20TH AVENUE OSHKOSH WI 54904 (920) 232-9002 LINDA CARLSON County: WINNEBAGO

CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 CLARITY CARE INC (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 PRODUCTIVE LIVING SYSTEMS INC (715) 831-3910 KIERSTEN KARLSEN 300 N WOODS EDGE DR STE 103 APPLETON WI 54914 DIVERSE OPTIONS INC (920) 748-6387 DAVID HOOD PO BOX 449 571 FENTON ST RIPON WI 54971-0449 BROOKEVIEW ASSISTED LIVING LLC (920) 232-9002 LINDA CARLSON 3504 W 20TH AVE OSHKOSH WI 54904

DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 7 Low/High rate: 4,076/4,076 Initial License: 06/30/2006

Type: Class:

CBRF CA Gender - Capacity: M/F - 8 Low/High rate: 4,252/4,252 Initial License: 08/25/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,599/6,599 Initial License: 10/09/2002

Type: Class:

DEVELOPMENTALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING DEVELOPMENTALLY DISABLED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M - 6 Low/High rate: 3,679/3,679 Initial License: 07/18/1980

Type: Class:

CBRF CNA Gender - Capacity: M/F - 5 Low/High rate: 4,933/5,130 Initial License: 06/21/1984

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 6,253/6,253 Initial License: 11/02/2004

Type: Class:

DEVELOPMENTALLY DISABLED

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,990/4,990 Initial License: 09/26/2011

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 5,567/5,719 Initial License: 04/13/1998

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,527/3,527 Initial License: 10/15/1999

Type: Class:

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 4,200/6,200 Initial License: 06/17/2009

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 133

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,688/3,800 Initial License: 01/28/2013

Type: Class:

ELDER LODGE (0014449) 1055 JACOBSEN RD NEENAH WI 54956 (920) 969-1002 THERESA FROEHLICH County: WINNEBAGO

ELDER LODGE (920) 540-5393 THERESA FROEHLICH PO BOX 957 NEENAH WI 54957-0957

ELIJAHS PLACE (410376) 1551 SOUTHLAND AVE OSHKOSH WI 54902 (920) 235-5599 KRIS KRENTZ County: WINNEBAGO Association Approval: Leading Age EMERALD VALLEY ASSISTED LIVING (0011362) 200 W VALLEY RD APPLETON WI 54915 (920) 830-6649 KATHERINE TEGEN County: WINNEBAGO EVERGREEN SHAREHAVEN HOME (410286) 1095 N WESTFIELD ST OSHKOSH WI 54902 (920) 233-2340 MARY STELTER County: WINNEBAGO Association Approval: Leading Age EVERGREEN TERRACE (410151) 1130 N WESTFIELD ST OSHKOSH WI 54903-1720 (920) 233-2340 DEBRA HERMAN County: WINNEBAGO FRIEDA MAE HAUS (0011681) 625 BONDOW DR NEENAH WI 54956 (920) 967-0001 ANNE ALTENHOFEN KRAUSE County: WINNEBAGO GARDENVIEW INC (410396) 1712 MIDWAY RD MENASHA WI 54952 (920) 733-4305 ANN COYLE County: WINNEBAGO HARBOR HOUSE OSHKOSH (0013423) 2220 BROOKVIEW CT OSHKOSH WI 54904 (920) 426-9900 DAVID CHAPMAN County: WINNEBAGO HERITAGE ASSISTED LIVING (410391) 2600 S HERITAGE WOODS DR APPLETON WI 54915 (920) 738-3003 DONNA SCHOEN County: WINNEBAGO Association Approval: Leading Age JOSEPHINE VERONICA HAUS (0011680) 635 BONDOW DR NEENAH WI 54956 (920) 967-0001 ANNE ALTENHOFEN KRAUSE County: WINNEBAGO LAKESHORE MANOR (0011466) 711 BAYSHORE DRIVE OSHKOSH WI 54901 (920) 426-2670 MICHELLE BURGER County: WINNEBAGO

BETHEL HOME INC (920) 235-4653 KRIS KRENTZ 225 N EAGLE ST OSHKOSH WI 54902 BAKA ENTERPRISES INC (920) 574-3833 KATHERINE R TEGEN 3232 N BALLARD RD STE 202 APPLETON WI 54911 EVERGREEN RETIREMENT COMMUNITY INC (920) 233-2340 MARY STELTER 1130 N WESTFIELD ST OSHKOSH WI 54902 EVERGREEN RETIREMENT COMMUNITY INC (920) 237-6220 DEBRA HERMAN 1130 N WESTFIELD ST OSHKOSH WI 54903-1720 ALTEN HAUS LLC (920) 730-9596 ANNE ALTENHOFEN KRAUSE 4640 GRAND MEADOWS DR APPLETON WI 54914 GARDENVIEW INC (920) 733-4305 ANN COYLE 1712 MIDWAY RD MENASHA WI 54952 AZURA OSHKOSH LLC (920) 426-9900 CARRIE ZOLADZ 6405 CENTURY AVE STE 104 MIDDLETON WI 53562 THEDACARE (920) 735-5560 DONNA SCHOEN 2600 S HERITAGE WOODS DR APPLETON WI 54915 ALTEN HAUS LLC (920) 730-9596 ANNE ALTENHOFEN KRAUSE 4640 GRAND MEADOWS DR APPLETON WI 54914 LAKESHORE CRL LLC (847) 509-8636 DOUGLAS CAMERON 875 N MICHIGAN AVE. STE 3740 CHICAGO IL 60611-1916

Gender - Capacity:

CBRF CNA M/F - 12 Low/High rate: 5,280/5,280 Initial License: 05/16/1994

Type: Class: Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 2,900/4,100 Initial License: 03/01/2006 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 5,940/6,138 Initial License: 12/04/1991

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 40 Low/High rate: 3,711/5,505 Initial License: 10/01/1983

Type: Class:

ADVANCED AGED PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 12 Low/High rate: 3,000/3,500 Initial License: 01/01/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,995/3,650 Initial License: 10/14/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 3,700/6,900 Initial License: 08/15/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,763/3,763 Initial License: 11/16/1994

Type: Class:

CBRF CNA Gender - Capacity: M/F - 10 Low/High rate: 3,000/3,500 Initial License: 01/01/2007

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING

CBRF CNA Gender - Capacity: M/F - 57 Low/High rate: 3,500/8,000 Initial License: 05/08/2006

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 134

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,750/6,107 Initial License: 06/15/2012

Type: Class:

MATTHEWS OF IRISH ROAD CBRF (0014157) 1760 IRISH RD NEENAH WI 54956 (312) 623-0884 DEANA MC KENZIE County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

MATTHEWS OF NEENAH I (0014160) 970 W AMERICAN DR NEENAH WI 54956 (920) 886-0491 JENNIFER VANDENBOOGARD County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,860/6,572 Initial License: 06/15/2012

Type: Class:

MATTHEWS OF NEENAH II (0014161) 990 W AMERICAN DR NEENAH WI 54956 (920) 886-3982 JENNIFER VANDENBOOGARD County: WINNEBAGO

MATTHEWS SENIOR HOUSING LLC (312) 623-0884 THOMAS OSTROM 700 N GREEN ST UNIT 401 CHICAGO IL 60643

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 4,860/6,572 Initial License: 06/15/2012

Type: Class:

NEXUS HOUSE (0012718) 2831 HARRISON STREET OSHKOSH WI 54901 (920) 233-5212 REBECCA SIMON County: WINNEBAGO NOVA COUNSELING SERVICES INC 2 (0010634) 3240 JACKSON ST OSHKOSH WI 54901 (920) 231-0143 HUGH HOLLY County: WINNEBAGO OAKWOOD MANOR (0011595) 2675 OMRO ROAD OSHKOSH WI 54904 (920) 235-0779 TIMOTHY J BURNS County: WINNEBAGO

LUTHERAN SOCIAL SERVICES OF WI & UPPER M (414) 281-4400 STACY CHRISTIANSEN 2831 HARRISON ST OSHKOSH WI 54901 NOVA COUNSELING SERVICES INC (920) 231-0143 HUGH HOLLY 3240 JACKSON ST OSHKOSH WI 54901 NEW HAVEN INC (920) 231-7900 TIMOTHY J BURNS PO BOX 851 OSHKOSH WI 54903-0851

CBRF AA Gender - Capacity: M - 20 Low/High rate: 37,006/37,006 Initial License: 05/06/2009

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS

CBRF AS Gender - Capacity: M/F - 50 Low/High rate: 4,153/5,488 Initial License: 08/31/2004

Type: Class:

ALCOHOL/DRUG DEPENDENT

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,625/4,725 Initial License: 10/18/2006

Type: Class:

PNUMA 3 (410538) 1955 CTY RD A NEENAH WI 54956 (920) 727-4827 AMY SCHMIDT County: WINNEBAGO PRAIRIE HOME I (0013018) 1463 KENWOOD DR MENASHA WI 54952 (920) 969-0526 TANYA NEUBERT County: WINNEBAGO

PNUMA HEALTH CARE INC (920) 867-4969 JEFFREY CHAUDOIR N3856 LOSS RD WEYAUWEGA WI 54983 PRAIRIE HOME ELDER SERVICES LLC (920) 969-0526 JOHN MC CARTHY 1463 KENWOOD DR MENASHA WI 54952

CBRF AA Gender - Capacity: M/F - 6 Low/High rate: 5,505/5,505 Initial License: 12/20/1997

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY WAIVER CERTIFIED INDEPENDENT CBRF APTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,600/6,000 Initial License: 10/01/2009

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 135

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 2,700/3,300 Initial License: 12/07/2000

Type: Class:

PRAIRIE HOME II (0009115) 1461 KENWOOD DR MENASHA WI 54952 (920) 886-0524 TANYA NEUBERT County: WINNEBAGO PRAIRIE HOME III (410552) 1459 KENWOOD DR MENASHA WI 54952 (920) 886-0538 TANYA NEUBERT County: WINNEBAGO REHABILITATION HOUSE INC (410111) 107 PROFESSIONAL PLAZA NEENAH WI 54956 (920) 725-2271 PATRICIA NAGEL County: WINNEBAGO RESPITE HOUSE (410406) 1325 EASTMAN ST OSHKOSH WI 54901 (920) 424-4073 TRACY FELDKAMP County: WINNEBAGO SERENITY PLACE I (0009570) 1538 W SIXTH AVE OSHKOSH WI 54902 (920) 233-8942 DIANE HOLLUB County: WINNEBAGO

PRAIRIE HOME ELDER SERVICES LLC (920) 969-0526 JOHN MC CARTHY 1463 KENWOOD DR MENASHA WI 54952 PRAIRIE HOME ELDER SERVICES LLC (920) 969-0526 JOHN MC CARTHY 1463 KENWOOD DR MENASHA WI 54952 REHABILITATION HOUSE INC (920) 725-2271 PATRICIA NAGEL 107 PROFESSIONAL PLAZA NEENAH WI 54956 CEREBRAL PALSY OF MIDEAST WISCONSIN IN (920) 424-4071 LORRAINE YARBROUGH PO BOX 1241 OSHKOSH WI 54903-1241 SERENITY PLACE INC (920) 751-8111 DIANE HOLLUB 208 BOSWORTH CT NEENAH WI 54956

CBRF CNA Gender - Capacity: M/F - 15 Low/High rate: 3,000/4,500 Initial License: 01/05/1999

Type: Class:

CBRF AS Gender - Capacity: M/F - 14 Low/High rate: 2,449/4,030 Initial License: 05/14/1981

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 4,334/6,266 Initial License: 03/01/1995

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ALCOHOL/DRUG DEPENDENT CORRECTIONAL CLIENTS EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING PHYSICALLY DISABLED PUBLIC FUNDING

CBRF CS Gender - Capacity: M/F - 7 Low/High rate: 2,988/3,498 Initial License: 02/22/2002

Type: Class:

SERENITY PLACE II (0009571) 19 E LINCOLN ST OSHKOSH WI 54901 (920) 233-8991 DIANE HOLLUB County: WINNEBAGO

SERENITY PLACE INC (920) 751-9047 DIANE HOLLUB 208 BOSWORTH CT NEENAH WI 54956

CBRF CS Gender - Capacity: M/F - 5 Low/High rate: 2,988/3,498 Initial License: 02/22/2002

Type: Class:

STERLING HOUSE OF NEENAH (410540) 2330 BRUCE ST NEENAH WI 54956 (920) 727-1120 CHRISTINE GREGORIUS County: WINNEBAGO STERLING HOUSE OF OSHKOSH (410541) 190 LAKE POINTE DR OSHKOSH WI 54904 (920) 232-8686 DEBORAH OPPERMAN County: WINNEBAGO SUMMIT HOUSE (410163) 2501 HARRISON ST OSHKOSH WI 54901 (920) 424-7772 JOHN SHEEHAN County: WINNEBAGO TOWARD TOMORROW (0014013) 1332 MONROE ST OSHKOSH WI 54901 (920) 231-4740 JOHN SHEEHAN County: WINNEBAGO

BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 CHRISTINE GREGORIUS 2330 BRUCE ST NEENAH WI 54956 BROOKDALE SENIOR LIVING COMMUNITIES IN (414) 918-5000 DEBORAH OPPERMAN 190 LAKE POINTE DR OSHKOSH WI 54904 WINNEBAGO COUNTY DHS (920) 236-4814 JOHN SHEEHAN 2501 HARRISON ST OSHKOSH WI 54901 WINNEBAGO COUNTY DHS (920) 236-4700 JOHN SHEEHAN 1332 MONROE OSHKOSH WI 54901

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 2,775/4,500 Initial License: 12/09/1997

Type: Class:

ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT EMOTIONALLY DISTURBED/MENTAL ILLNESS EMOTIONALLY DISTURBED/MENTAL ILLNESS

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,060/3,420 Initial License: 12/09/1997

Type: Class:

Gender - Capacity:

CBRF AS M/F - 8 Low/High rate: 4,200/4,200 Initial License: 07/14/1988

Type: Class:

Gender - Capacity:

CBRF AS M/F - 12 Low/High rate: 4,382/4,382 Initial License: 01/31/2012

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 136

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 64 Low/High rate: 3,865/6,675 Initial License: 07/23/1998

Type: Class:

VNA ASSISTED LIVING (410559) 1533 LYON DR NEENAH WI 54956 (920) 727-5544 THERESA PICHELMEYER County: WINNEBAGO WEBSTER MANOR (410448) 515 S WEBSTER AVE OMRO WI 54963 (920) 685-5776 DIANN ROBERTS County: WINNEBAGO

VALLEY VNA ASSISTED LIVING INC (920) 727-5544 THERESA PICHELMEYER 1533 LYON DR NEENAH WI 54956 NEW HAVEN INC (920) 231-7900 TIM BURNS PO BOX 851 OSHKOSH WI 54903-0851

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,325/4,425 Initial License: 08/16/1996

Type: Class:

WESTBROOKE MANOR ASSISTED LIVING & MEMORY CAR BROOKEVIEW ASSISTED LIVING LLC (920) 232-9920 3508 W 20TH AVE LINDA C CARLSON OSHKOSH WI 54904 3504 W 20TH AVE (920) 232-9920 LINDA C CARLSON OSHKOSH WI 54904 County: WINNEBAGO A TOUCH OF HOME 2 (0013696) 720 CYPRESS AVE MARSHFIELD WI 54449 (715) 384-4851 THOMAS SHILTS County: WOOD THOMAS/CATHERIN SHILTS (715) 387-2080 CATHIE SHILTS M225 TURTLE RIDGE RD MARSHFIELD WI 54449

CBRF CNA Gender - Capacity: M/F - 25 Low/High rate: 3,127/6,200 Initial License: 11/28/2011

Type: Class:

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING WAIVER CERTIFIED INDEPENDENT CBRF APTS ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,368/2,750 Initial License: 08/22/2011

Type: Class:

A TOUCH OF HOME 3 (0014266) 612 E 25TH ST MARSHFIELD WI 54449 (715) 207-0153 TOM SHILTS County: WOOD

T & C ADULT HOMES (715) 387-2080 CATHIE SHILTS M225 TURTLE RIDGE RD MARSHFIELD WI 54449

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,400/3,800 Initial License: 07/11/2012

Type: Class:

ADAMS AVENUE GROUP HOME (0013144) 613 W 11TH ST MARSHFIELD WI 54449 (715) 389-2720 SUSAN ACKERMAN County: WOOD AIRPORT AVENUE (0009452) 1010 AIRPORT AVENUE WISCONSIN RAPIDS WI 54494 (715) 421-4244 TONYA CALLAHAN County: WOOD ANGIES GOLD HORIZONS ASSISTED LIVING LLC (001435 208 W 25TH ST MARSHFIELD WI 54449 (715) 389-1907 ANGELA JACOBY County: WOOD

CLARITY CARE (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 WOOD COUNTY HUMAN SERVICES (715) 421-8840 TONYA CALLAHAN 2611 12TH STREET SOUTH WISCONSIN RAPIDS WI 54494 ANGELA R JACOBY (715) 676-2790 ANGELA R JACOBY 208 W 25TH ST MARSHFIELD WI 54449

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,411/6,411 Initial License: 01/01/2010

Type: Class:

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,940/3,255 Initial License: 12/07/2001

Type: Class:

CBRF CS Gender - Capacity: M/F - 9 Low/High rate: 3,500/4,800 Initial License: 03/04/2013

Type: Class:

APPLE AVENUE GROUP HOME (0013143) 1406 S APPLE AVE MARSHFIELD WI 54449 (715) 486-8421 SUSAN ACKERMAN County: WOOD

CLARITY CARE (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 5,073/5,073 Initial License: 01/01/2010

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 137

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 54 Low/High rate: 3,500/4,500 Initial License: 10/27/2010

Type: Class:

ARBORVIEW COURT (0013373) 3750 BLUE VIOLET LN WISCONSIN RAPIDS WI 54494 (715) 424-3758 KAREN TRZEBIATOWSKI County: WOOD BROWNS ELMWOOD INN (0012410) 521 ELM STREET WISCONSIN RAPIDS WI 54494 (715) 421-2244 TERRY HOWARD County: WOOD

CRYSTAL FOUNTAINS ASSISTED LIVING LLC (715) 342-9100 PATRICIA J ARNOLD 3450 BRIDLEWOOD DR PLOVER WI 54467 TERRY HOWARD (715) 305-5591 TERRY HOWARD 8003 WARD BLVD ARPIN WI 54410

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ALCOHOL/DRUG DEPENDENT DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED PUBLIC FUNDING

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,250/3,100 Initial License: 06/10/2008

Type: Class:

BROWNS MAPLE INN (0009866) 8203 CTY ROAD T ARPIN WI 54410 (715) 652-2338 TERRY OR CAROL HOWARD County: WOOD

TERRY OR CAROL HOWARD (715) 652-6167 DAVID E THEWES JR 6409 W MAIN ST ARPIN WI 54410

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 2,950/2,950 Initial License: 03/12/2003

Type: Class:

DEERVIEW MEADOWS BLDG D (0011538) 1316 D HUME AVENUE MARSHFIELD WI 54449 (715) 384-9054 AUDREY HOMER County: WOOD

DEERVIEW MEADOW ASSISTED LIVING LLC (608) 286-1231 WILLIAM/CHERYL TESNOW 1130 ALRITA COURT APT 5 MADISON WI 53713

CBRF CNA Gender - Capacity: M/F - 17 Low/High rate: 2,900/3,700 Initial License: 06/20/2006

Type: Class:

DELANEY HOME LLC (0011989) 5342 3RD AVENUE PITTSVILLE WI 54466 (715) 884-2782 TIMOTHY DELANEY County: WOOD DRAKE HOUSE I THE (611009) 800 SOUTH DRAKE AVENUE MARSHFIELD WI 54449 (715) 389-9902 PHYLLIS LEMOINE County: WOOD

(715) 884-2782 TIMOTHY DELANEY PO BOX E PITTSVILLE WI 54466 DRAKE HOUSE LLC (THE) (715) 693-4236 PHYLLIS LEMOINE 1061 WAMBOLD DRIVE MOSINEE WI 54455

CBRF CS Gender - Capacity: M/F - 8 Low/High rate: 1,750/2,400 Initial License: 07/06/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,600/3,418 Initial License: 12/18/1996

Type: Class:

DRAKE HOUSE II THE (611041) 212 COLUMBUS DRIVE MARSHFIELD WI 54449 (715) 389-1200 PHYLLIS LEMOINE County: WOOD

DRAKE HOUSE II LLC (THE) (715) 693-4236 PHYLLIS LEMOINE 1016 WAMBOLD DRIVE MOSINEE WI 54455

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 2,790/5,120 Initial License: 03/10/1998

Type: Class:

DRAKE HOUSE III THE (0014328) 501 W 13TH ST MARSHFIELD WI 54449 (715) 384-9022 PHYLLIS LEMOINE County: WOOD GOLD HORIZONS LS LLC (0014355) 1704 E MCMILLAN ST MARSHFIELD WI 54449 (715) 389-8535 LORI A SCHMITT County: WOOD

PHYLLIS LEMOINE (715) 693-4236 PHYLLIS LEMOINE 1061 WAMBOLD DR MOSINEE WI 54455 LORI A SCHMITT (715) 384-5814 LORI A SCHMITT 1704 E MCMILLAN ST MARSHFIELD WI 54449

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 2,180/2,780 Initial License: 10/31/2012

Type: Class:

ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 3,500/4,800 Initial License: 03/04/2013

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 138

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 1,895/3,145 Initial License: 07/01/2000

Type: Class:

HARMONY OF WISCONSIN RAPIDS I (0009023) 2230 14TH STREET SOUTH WISCONSIN RAPIDS WI 54494 (715) 421-2121 CELESTE NEUMANN-ZURFLUH County: WOOD HARMONY OF WISCONSIN RAPIDS II (0009381) 2230 JAMES COURT WISCONSIN RAPIDS WI 54494 (715) 421-2121 CELESTE NEUMANN-ZURFLUH County: WOOD HEWITT HOUSE (610212) 11002 MAIN STREET HEWITT WI 54441 (715) 389-2281 DEBBIE SCHIEBER County: WOOD HILLTOP ASSISTED LIVING ALPINE TERRACE (0014168) 1610 25TH AVE SOUTH WISCONSIN RAPIDS WI 54494 (715) 423-1610 ANITA WHETSTONE County: WOOD

HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVE #101 MENOMONEE FALLS WI 53051 HARMONY LIVING CENTERS LLC (262) 255-3606 DEE THIEME N94 W17900 APPLETON AVENUE MENOMONEE FALLS WI 53051 (715) 652-2301 DEBBIE SCHIEBER M525 E MCMILLAN ST MARSHFIELD WI 54449 HILLTOP AFFILIATES INC (715) 423-7400 ANITA WHETSTONE 630 PEPPER AVE WISCONSIN RAPIDS WI 54494

ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING DEVELOPMENTALLY DISABLED PHYSICALLY DISABLED PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 22 Low/High rate: 1,215/4,200 Initial License: 07/25/2001

Type: Class:

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 3,600/3,800 Initial License: 09/16/1993

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 12 Low/High rate: 2,975/6,000 Initial License: 04/24/2012

Type: Class:

HILLTOP ESTATES (0012662) 914 STATE HWY 73 SOUTH WISCONSIN RAPIDS WI 54494 (715) 423-7400 ANITA WHETSTONE County: WOOD HILLTOP OF PEPPER (0010105) 630 PEPPER AVENUE WISCONSIN RAPIDS WI 54494 (715) 423-7400 ANITA WHETSTONE County: WOOD OUR HOUSE ASSISTED CARE ON 16TH ST (0013445) 2941 16TH ST SOUTH WISCONSIN RAPIDS WI 54494 (715) 421-3060 PAMELA PAVEK County: WOOD OUR HOUSE SENIOR LIVING (0013444) 2711 12TH ST SOUTH WISCONSIN RAPIDS WI 54494 (715) 423-1700 PAMELA PAVEK County: WOOD PEACH AVENUE GROUP HOME (0013145) 2401 S PEACH AVE MARSHFIELD WI 54449 (715) 389-2854 SUSAN ACKERMAN County: WOOD PINE RIDGE ASSISTED LIVING (0012090) 491 25TH STREET N WISCONSIN RAPIDS WI 54494 (715) 421-0045 GAIL WILKINS County: WOOD PINE RIDGE ASSISTED LIVING MEM CAR (0012698) 2440 BAKER STREET WISCONSIN RAPIDS WI 54494 (715) 421-0045 GAIL WILKINS County: WOOD

HILLTOP AFFILIATES INC (715) 423-7400 ANITA WHETSTONE 630 PEPPER AVENUE WISCONSIN RAPIDS WI 54494 HILLTOP AFFILIATES INC (715) 423-7400 ANITA WHETSTONE 630 PEPPER AVENUE WISCONSIN RAPIDS WI 54494 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 KSMS OUR HOUSE LLC (317) 280-8455 KAREN KWITEK 350 S 85TH ST WAUSAU WI 54403 CLARITY CARE (920) 236-6560 SANDY DETERT 424 WASHINGTON AVE OSHKOSH WI 54901 PINE RIDGE ASSISTED LIVING (608) 209-9712 FRED/SANDY MILLER 491 25TH STREET N WISCONSIN RAPIDS WI 54494 PINE RIDGE ASSISTED LIVING (715) 421-0045 GAIL WILKINS 491 N 25TH STREET WISCONSIN RAPIDS WI 54494

CBRF AA Gender - Capacity: M/F - 8 Low/High rate: 3,500/6,500 Initial License: 04/01/2009

Type: Class:

CBRF CNA Gender - Capacity: M/F - 21 Low/High rate: 2,975/4,900 Initial License: 08/12/2003

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,125/3,125 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,125/4,125 Initial License: 09/30/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 6 Low/High rate: 6,299/6,299 Initial License: 01/01/2010

Type: Class:

CBRF CNA Gender - Capacity: M/F - 48 Low/High rate: 3,000/3,500 Initial License: 10/10/2007

Type: Class:

CBRF CNA Gender - Capacity: M/F - 18 Low/High rate: 3,300/5,000 Initial License: 05/01/2009

Type: Class:

Wisconsin Department of Health Services

Division of Quality Assurance CENTRAL OFFICE

Directory Updated 03/06/2013 Page 139

Public Directory

By County, Facility Name For Facility Type CBRF

Facility Name and Address Phone Number / Contact Person

Licensee Name and Phone Mailing Address

Specialty Programs

CBRF CNA Gender - Capacity: M/F - 8 Low/High rate: 13,680/18,500 Initial License: 04/12/2010

Type: Class:

SOLARTE RESIDENCE (0013278) 1171 21ST ST NORTH WISCONSIN RAPIDS WI 54494 (715) 421-2676 TERRY HOWARD County: WOOD STONEY RIVER ASSISTED LIVING (0013575) 1204 W MCMILLAN ST MARSHFIELD WI 54449 (715) 207-6423 TERRY HOWARD County: WOOD

BROWNS LIVING LLC (715) 652-2338 TERRY HOWARD 6409 W MAIN ST ARPIN WI 54410 FIRST PHOENIX LLC MARSHFIELD (715) 305-5591 DAVID THEWES 6409 W MAIN ST ARPIN WI 54410

DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL ILLNESS TRAUMATIC BRAIN INJURY ADVANCED AGED DEVELOPMENTALLY DISABLED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING TERMINALLY ILL ADVANCED AGED IRREVERSIBLE DEMENTIA/ALZHEIMER'S PUBLIC FUNDING ADVANCED AGED EMOTIONALLY DISTURBED/MENTAL ILLNESS IRREVERSIBLE DEMENTIA/ALZHEIMER'S PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

CBRF CNA Gender - Capacity: M/F - 60 Low/High rate: 3,500/6,000 Initial License: 01/17/2011

Type: Class:

WELLINGTON PLACE OF BIRON (0012044) 1661 SOUTH BIRON DRIVE WISCONSIN RAPIDS WI 54494 (715) 423-5600 AMANDA WILLFAHRT County: WOOD WELLS NATURE VIEW I (610269) 1016 SOUTH ADAMS AVENUE MARSHFIELD WI 54449 (715) 384-7615 JAMES WELLS County: WOOD WELLS NATURE VIEW II (611047) 601 EAST 21ST STREET MARSHFIELD WI 54449 (715) 387-1756 RONALD WELLS County: WOOD WELLS NATURE VIEW III (0009393) 2711 SOUTH APPLE AVENUE MARSHFIELD WI 54449 (715) 384-7882 RON WELLS County: WOOD

WELLINGTON HOMES OF WISCONSIN LLC (703) 868-0503 AMANDA WILLFAHRT 1661 SOUTH BIRON DRIVE WISCONSIN RAPIDS WI 54494 WELLS NATURE VIEW INC (715) 384-7615 JAMES WELLS 1016 SOUTH ADAMS AVENUE MARSHFIELD WI 54449 WELLS NATURE VIEW SENIOR CITIZENS HOME (715) 387-1756 RONALD WELLS 601 EAST 21ST STREET MARSHFIELD WI 54449 WELLS NATURE VIEW SENIOR CITIZENS ASST L (715) 384-7615 JUDY WELLS 2711 SOUTH APPLE AVENUE MARSHFIELD WI 54449

Gender - Capacity:

CBRF CNA M/F - 28 Low/High rate: 3,548/4,798 Initial License: 09/07/2007

Type: Class:

Gender - Capacity:

CBRF CNA M/F - 20 Low/High rate: 3,350/4,900 Initial License: 02/23/1996

Type: Class: Type: Class:

CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,275/3,275 Initial License: 10/10/1997 CBRF CNA Gender - Capacity: M/F - 20 Low/High rate: 3,350/3,350 Initial License: 12/06/2001

Type: Class:

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