Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 43061300 1014 CAH 521309 25 HSPLACU1 SOUTHERN MOUNDVIEW MEMORIAL HOSPITAL AND CLINICS 402 W LAKE ST FRIENDSHIP, WI 53934 PEREZ-GUERRA, FRANK BRONIEC, DIANA BRONIEC, DIANA Phone FY End Fax Accredited Participation Date (608)339-3331 DECEMBER (608)339-9385 NO 04/01/2001 ADAMS 1065 11019500 CAH 521359 HSPLACU63 35 NORTHERN MEMORIAL MEDICAL CENTER 1615 MAPLE LANE ASHLAND, WI 54806 DOUGLAS, JASON TUTTLE, KATHY HANSEN, KAREN (715)685-5500 SEPTEMBER (715)685-4022 YES 10/01/2007 ASHLAND 1018 521315 HSPLACU8 11016200 CAH 25 MAYO CLINIC HEALTH SYSTEM-NORTHLAND 1222 E WOODLAND AVE BARRON, WI 54812 HELMERS, RICHARD MILLER, LORI (715)537-3186 DECEMBER (715)537-6902 YES 09/01/2001 BARRON 1058 11011600 CAH 521353 HSPLACU217 25 WESTERN CUMBERLAND MEMORIAL HOSPITAL 1110 7TH AVENUE CUMBERLAND, WI 54829 GUTSCH, MICHAEL LINDBERG, ROBERT LINDBERG, ROBERT (715)822-7500 JUNE (715)822-7151 YES 08/19/2005 BARRON *Type is LTC or Hospital bt 1 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11006900 82 ACUTE 520011 HSPLACU52 40 MARSHFIELD MEDICAL CENTER - RICE LAKE 1700 WEST STOUT STREET RICE LAKE, WI 54868 GROSETH, BRADLEY 301 11023500 ACUTE 520193 HSPLACU142 167 NORTHEASTERN AURORA BAYCARE MEDICAL CTR 2845 GREENBRIER RD GREEN BAY, WI 54311 MEYER, DANIEL SCHROEDER, HEATHER JERDEE, AMY OLSON, JOHN JOHNSON, SHERRY BARRON Phone FY End Fax Accredited Participation Date (715)234-1515 SEPTEMBER (715)236-6342 YES 07/01/1966 (920)288-8000 DECEMBER (920)288-3040 YES 11/15/2001 BROWN 147 11010200 ACUTE 520049 HSPLACU11 244 NORTHEASTERN BELLIN MEMORIAL HOSPITAL 744 S WEBSTER AVE GREEN BAY, WI 54305 WOLESKE, CHRISTINE HIEB, LAURA WOLESKE, CHRISTINE DIETSCHE, JAMES BROWN (920)433-3500 SEPTEMBER (920)433-3707 YES 07/01/1966 263 10065900 PSYCH 524038 HSPLPSY1 80 NORTHEASTERN BELLIN PSYCHIATRIC CENTER 301 E ST JOSEPH ST GREEN BAY, WI 54301 BAENEN, SHARLA PATZ, DEBBIE WOLESKE, CHRIS (920)433-3630 (920)437-0533 YES 08/29/1990 BROWN *Type is LTC or Hospital bt 2 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 10064500 213 PSYCH 524014 16 HSPLPSY2 NORTHEASTERN BROWN COUNTY COMMUNITY TREATMENT CTR 3150 GERSHWIN DRIVE GREEN BAY, WI 54311 BEHLING, SAMANTHA BEHLING, SAMANTHA Phone FY End Fax Accredited Participation Date (920)391-4700 DECEMBER (920)391-4872 NO 11/05/1969 BROWN 259 10065600 SATELLITE HSPSAT001 16 NORTHEASTERN LIBERTAS GREEN BAY 1701 DOUSMAN ST GREEN BAY, WI 54303 CHARLIER, BRIAN HAFEMAN, PAULA DOXTATOR, ELAINE (920)498-8600 JUNE (920)496-2027 YES BROWN 18 11013800 ACUTE 520097 HSPLACU112 158 NORTHEASTERN ST MARYS HOSPITAL MEDICAL CTR 1726 SHAWANO AVE GREEN BAY, WI 54303 CHARLIER, BRIAN HAFEMAN, PAULA (920)498-4200 JUNE (920)431-3248 YES 07/01/1966 BROWN 19 11012100 ACUTE 520075 HSPLACU121 517 NORTHEASTERN ST VINCENT HOSPITAL 835 S VAN BUREN ST GREEN BAY, WI 54301 CHARLIER, BRIAN HAFEMAN, PAULA (920)433-0111 JUNE (920)431-3248 YES 07/01/1966 BROWN *Type is LTC or Hospital bt 3 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 322 PSYCH 524041 HSPLPSY14 72 WILLOW CREEK BEHAVIORAL HEALTH 1351 ONTARIO RD GREEN BAY, WI 54311 ZARECKY, DANIEL DENIL, ALISON SHAHEEN, JIM Phone FY End Fax Accredited Participation Date (901)328-1220 DECEMBER (901)469-7211 YES 02/27/2017 BROWN 1034 11016600 CAH 521331 HSPLACU17 25 BURNETT MEDICAL CENTER 257 W ST GEORGE AVE GRANTSBURG, WI 54840 LEWIS, GORDON MOORE, JAMES MOORE, NED (715)463-5353 SEPTEMBER (715)463-2423 NO 10/01/2003 BURNETT 1020 11015300 CAH 521317 HSPLCRI11 25 NORTHEASTERN ASCENSION CALUMET HOSPITAL 614 MEMORIAL DRIVE CHILTON, WI 53014 DERKS, JENNIFER STRODTHOFF, JUDITH WEBER, JENNIFER (920)849-2386 JUNE (920)849-7510 YES 11/02/2001 CALUMET 1017 11018500 CAH 521314 HSPLACU15 25 MAYO CLINIC HEALTH SYSTEM-CHIPPEWA VALLEY 1501 THOMPSON ST BLOOMER, WI 54724 HELMERS, RICHARD MILLER, LORI (715)568-2000 DECEMBER (715)568-6196 YES 07/01/2001 CHIPPEWA *Type is LTC or Hospital bt 4 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11007500 15 ACUTE 520017 HSPLACU101 193 ST JOSEPHS HOSPITAL 2661 COUNTY HWY I CHIPPEWA FALLS, WI 54729 WAGNER, JOHN DRAYTON, JENNIFER Phone FY End Fax Accredited Participation Date (715)717-7200 JUNE (715)717-1694 YES 07/01/1966 CHIPPEWA 1013 11006500 CAH 521311 HSPLACU131 24 WESTERN ASCENSION OUR LADY OF VICTORY HOSPITAL 1120 PINE ST STANLEY, WI 54768 GAPKO, DAWN RENAUD, KIMBERLY CHAPEK, LACEY (715)644-5571 JUNE (715)644-6221 NO 03/07/2001 CHIPPEWA 1026 11010500 CAH 521323 HSPLACU62 25 MARSHFIELD MEDICAL CENTER - NEILLSVILLE 216 SUNSET PLACE NEILLSVILLE, WI 54456 NEVILLE, RYAN ZILLMAN, SALLY (715)743-3101 DECEMBER (715)743-8015 NO 08/01/2002 CLARK 1042 11012800 CAH 521338 HSPLACU23 25 SOUTHERN PRAIRIE RIDGE HEALTH 1515 PARK AVE COLUMBUS, WI 53925 RUSSELL, JOHN HENDRIX, JAMIE FISH, FRANCIS (920)623-2200 SEPTEMBER (920)623-3546 YES 07/01/2004 COLUMBIA *Type is LTC or Hospital bt 5 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11009500 80 ACUTE 520041 HSPLACU27 73 SOUTHERN DIVINE SAVIOR HEALTHCARE 2817 NEW PINERY ROAD PORTAGE, WI 53901 DECKER, MICHAEL BAUMAN, JAN BAUMAN, JAN Phone FY End Fax Accredited Participation Date (608)742-4131 JUNE (608)742-6098 YES 07/01/1966 COLUMBIA 1033 32811100 CAH 521330 HSPLACU71 25 WESTERN CROSSING RIVERS HEALTH MEDICAL CENTER 37868 US HWY 18 PRAIRIE DU CHIEN, WI 53821 STEINER, GARITH PRITCHETT, JENNY NELSON, JULIA STEINER, GARITH CRAWFORD (608)357-2000 DECEMBER (608)357-2100 YES 10/01/2003 249 10063400 PSYCH 524008 HSPLPSY5 394 SOUTHERN MENDOTA MENTAL HEALTH INSTITUTE 301 TROY DR MADISON, WI 53704 VAN RYBROEK, GREG VON HADEN, LISA LANE, PAUL (608)301-1000 JUNE (608)301-1390 YES 07/01/1966 DANE 313 11025100 LT 522008 HSPLACU992 58 SOUTHERN SELECT SPECIALTY HOSPITAL MADISON 801 BRAXTON PLACE MADISON, WI 53715 GUNDERSON, MONICA BEAUDETTE, JEAN (608)260-2700 DECEMBER (608)260-2729 YES 06/01/2007 DANE *Type is LTC or Hospital bt 6 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11022900 71 ACUTE 520083 HSPLACU111 440 SOUTHERN SSM HEALTH ST MARY'S HOSPITAL - MADISON 700 SOUTH PARK ST MADISON, WI 53715 ROZENFELD, JON MALONE, GINGER ROZENFELD, JON Phone FY End Fax Accredited Participation Date (608)251-6100 DECEMBER (608)258-6731 YES 07/01/1966 DANE 248 11001700 ACUTE 520089 HSPLACU66 426 SOUTHERN UNITYPOINT HEALTH - MERITER 202 S PARK ST MADISON, WI 53715 ERICKSON, SUSAN CASALI, SHERRY ARNETT, JAMES (608)417-6000 DECEMBER YES 07/01/1966 DANE 752 11001700 SATELLITE HSPSAT005 SOUTHERN 22 UNITYPOINT HEALTH MERITER CHILD & ADOLESCENT PSYCH CASE, MONICA 8102 WELLNESS WAY CASALI, SHERRY MADISON, WI 53719 WIESE III, HOWARD (608)417-5336 DECEMBER (608)417-5334 YES DANE 125 11022000 ACUTE 520098 HSPLACU127 672 SOUTHERN UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY 600 HIGHLAND AVENUE MADISON, WI 53792 RANSOM, RIC REES, SUE NEWCOMER, PETER (608)261-0025 JUNE (608)203-1016 YES 07/01/1966 DANE *Type is LTC or Hospital bt 7 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County (608)265-7050 (608)265-5568 NO 09/23/2009 UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS 529802 WITH00232 Phone FY End Fax Accredited Participation Date TRANSPLANT 600 HIGHLAND AVE MADISON, WI 53792 DANE 321 REHAB 523028 HSPLRHB01 50 UW HEALTH REHABILITATION HOSPITAL 5115 N BILTMORE LN MADISON, WI 53718 BOWMAN, KENNETH HAGAN, NANCY PUTNAM, CATHERINE (608)592-8100 DECEMBER (608)592-8170 YES 10/26/2015 DANE 1046 11007200 CAH 521343 HSPLACU122 35 SOUTHERN STOUGHTON HOSPITAL 900 RIDGE ST STOUGHTON, WI 53589 DEGROOT, DANIEL HERMES, AMY ABEY, MICHELLE (608)873-6611 SEPTEMBER (608)873-2315 YES 10/01/2004 DANE 199 11012200 ACUTE 520076 HSPLACU10 125 SOUTHERN MARSHFIELD MEDICAL CENTER - BEAVER DAM 707 S UNIVERSITY AVE BEAVER DAM, WI 53916 GILENE, JOSEPH SMITH, COLLETTE BRUINS, MELANIE (920)887-7181 JUNE (920)887-7973 YES 07/01/1966 DODGE *Type is LTC or Hospital bt 8 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11015400 105 ACUTE 520116 HSPLACU132 95 SOUTHERN WATERTOWN REGIONAL MEDICAL CENTER 125 HOSPITAL DRIVE WATERTOWN, WI 53098 KEDDINGTON, RICHARD GARABALDI, ISABELLE GARABALDI, ISABELLE Phone FY End Fax Accredited Participation Date (920)261-4210 AUGUST (920)261-3940 YES 07/01/1966 DODGE 1031 11008100 CAH 521327 HSPLACU134 25 SOUTHERN WAUPUN MEMORIAL HOSPITAL 620 W BROWN ST WAUPUN, WI 53963 THURMER, DEANN THURMER, DEANN (920)324-6512 DECEMBER (920)324-2085 YES 02/01/2003 DODGE 1064 11018400 CAH 521358 HSPLCRI20 25 NORTHEASTERN DOOR COUNTY MEDICAL CENTER 323 SOUTH 18TH AVENUE STURGEON BAY, WI 54235 STEPHENS, BRIAN KRAUSE, CHRISTA STEPHENS, BRIAN (920)743-5566 JUNE NO 06/13/2006 DOOR 1032 11022400 CAH 521329 HSPLACU92 25 NORTHERN ESSENTIA HEALTH ST MARY'S HOSPITAL - SUPERIOR 3500 TOWER AVE SUPERIOR, WI 54880 JACOBSON, TERRY PEARSON, KIM GARVEY, JIM (715)817-7000 JUNE YES 08/01/2003 DOUGLAS *Type is LTC or Hospital bt 9 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11006200 1044 CAH 521340 HSPLACU68 25 MAYO CLINIC HEALTH SYSTEM-RED CEDAR 2321 STOUT RD MENOMONIE, WI 54751 HELMERS, RICHARD BOSSE, PATTY Phone FY End Fax Accredited Participation Date (715)235-5531 DECEMBER (715)233-7645 YES 07/02/2004 DUNN 303 11023800 ACUTE 520196 HSPLACU144 13 OAKLEAF SURGICAL HOSPITAL 1000 OAKLEAF WAY ALTOONA, WI 54720 HARGRAVE-THOMAS, ANNE SVEE, PENNY SVEE, PENNY (715)831-8130 DECEMBER (715)831-7894 YES 01/12/2002 EAU CLAIRE 323 ACUTE 520210 HSPLACU222 44 MARSHFIELD MEDICAL CENTER - EAU CLAIRE 2310 CRAIG RD EAU CLAIRE, WI 54701 PRIEST, BILL JOCHIMSEN, PAM GEHLER, MIRIAM (715)858-8100 SEPTEMBER (715)858-8200 YES 12/31/2018 EAU CLAIRE 48 11011800 ACUTE 520070 HSPLACU55 304 MAYO CLINIC HEALTH SYSTEM IN EAU CLAIRE 1221 WHIPPLE ST EAU CLAIRE, WI 54703 HELMERS, RICHARD WHITE, PAM CRAIG, JASON (715)838-3311 DECEMBER (715)838-3743 YES 07/01/1966 EAU CLAIRE *Type is LTC or Hospital bt 10 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11007100 17 ACUTE 520013 HSPLACU79 344 WESTERN SACRED HEART HOSPITAL 900 W CLAIREMONT AVE EAU CLAIRE, WI 54701 BAGNALL, ANDREW DRAYTON, JENNIFER STARMANN-HARRISON, MARY Phone FY End Fax Accredited Participation Date (715)717-4121 JUNE (715)717-6076 YES 07/01/1966 EAU CLAIRE 231 10062400 PSYCH 524025 HSPLPSY4 25 NORTHEASTERN FOND DU LAC COUNTY ACUTE PSYCH UNIT 459 E FIRST ST FOND DU LAC, WI 54935 MUSUNURU, JAGADEESWARA KORNFEHL, BRITTANY VANEVEN HOVEN, GERI (920)929-3500 DECEMBER (920)929-3402 NO 12/17/1980 FOND DU LAC 120 11013000 ACUTE 520088 HSPLACU93 146 NORTHEASTERN ST AGNES HOSPITAL 430 E DIVISION ST FOND DU LAC, WI 54935 VERGOS, KATHERINE VERGOS, KATHERINE (920)929-2300 DECEMBER (920)926-4864 YES 07/01/1966 FOND DU LAC 1024 11013200 CAH 521321 HSPLACU74 18 NORTHEASTERN RIPON MEDICAL CENTER 845 PARKSIDE ST RIPON, WI 54971 THURMER, DEANN THURMER, DEANN (920)748-3101 DECEMBER (920)745-7926 YES 04/01/2002 FOND DU LAC *Type is LTC or Hospital bt 11 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11015200 1048 CAH 521344 HSPLACU16 25 SOUTHERN GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS 205 PARKER ST BOSCOBEL, WI 53805 HARTBERG, DAVID BRAUDT, THERESA DAX, JENNY Phone FY End Fax Accredited Participation Date (608)375-4112 DECEMBER (608)375-6208 NO 10/01/2004 GRANT 1025 1941359536 CAH 521322 HSPLACU39 25 SOUTHERN GRANT REGIONAL HEALTH CENTER 507 S MONROE ST LANCASTER, WI 53813 SMITH, DAVID CHAMBERS, TAMARA BANDY, DAWN (608)723-2143 DECEMBER (608)723-4464 YES 05/01/2002 GRANT 1063 SATELLITE HSPSAT13 SOUTHERN 10 SOUTHWEST HEALTH CARE BEHAVIORAL SERVICES 1185 NORTH ELM STREET PLATTEVILLE, WI 53818 ROHRBACH, DAN ZICK, LINDA ZICK, LINDA (608)348-2331 (608)342-3026 YES GRANT 11000600 1059 CAH 521354 HSPLACU219 25 SOUTHERN SOUTHWEST HEALTH CENTER 1400 EAST SIDE RD PLATTEVILLE, WI 53818 ROHRBACH, DAN WYLESKY-DURST, REBECCA MILLIN, SHANNON (608)348-2331 JUNE YES 11/01/2005 GRANT *Type is LTC or Hospital bt 12 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11011000 1060 CAH 521355 HSPLCRI19 25 NORTHEASTERN THEDACARE MEDICAL CENTER - BERLIN INC 225 MEMORIAL DRIVE BERLIN, WI 54923 BENDING, TAMMY MORK, PAM BENDING, TAMMY MORK, PAM GREEN LAKE (920)361-1313 DECEMBER (920)361-5579 YES 12/01/2005 56 11008400 ACUTE 520028 HSPLACU67 95 SOUTHERN THE MONROE CLINIC 2005 5TH STREET MONROE, WI 53566 SANDERS, MICHAEL STEINKE, JASON PIPP, DARREN (608)324-1000 DECEMBER (608)324-1114 YES 07/01/1966 Phone FY End Fax Accredited Participation Date GREEN 1056 11008700 CAH 521352 HSPLACU60 25 SOUTHERN UPLAND HILLS HEALTH 800 COMPASSION WAY DODGEVILLE, WI 53533 SCHNEDLER, LISA HEBGEN, LYNN PUSTINA, KARL (608)930-8000 SEPTEMBER (608)930-7250 YES 01/01/2005 IOWA 1037 11018300 CAH 521333 HSPLACU14 25 WESTERN BLACK RIVER MEMORIAL HOSPITAL 711 W ADAMS ST BLACK RIVER FALLS, WI 54615 WHITE JACOBS, MARY BETH BERGERSON, MELISSA WINN, HOLLY (715)284-5361 DECEMBER (715)284-1390 YES 02/05/2004 JACKSON *Type is LTC or Hospital bt 13 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11011900 133 ACUTE 520071 HSPLACU31 49 SOUTHEASTERN FORT MEMORIAL HOSPITAL 611 SHERMAN AVE E FORT ATKINSON, WI 53538 WALLACE, MICHAEL WIESMANN, MARIE NELSON, JAMES Phone FY End Fax Accredited Participation Date (920)568-5000 SEPTEMBER (920)568-5412 YES 07/01/1966 JEFFERSON 134 11014700 ACUTE 520109 HSPLACU42 40 SOUTHERN MILE BLUFF MEDICAL CENTER 1050 DIVISION ST MAUSTON, WI 53948 O'KEEFE, JAMES SURGUY, JEAN SURGUY, JEAN (608)847-6161 SEPTEMBER (608)847-3881 YES 07/01/1966 JUNEAU 1001 11022500 ACUTE 520189 HSPLACU6 74 SOUTHEASTERN AURORA MEDICAL CTR KENOSHA 10400 75TH ST KENOSHA, WI 53142 JUST, LISA JAMIESON, DONNA (262)948-5600 DECEMBER (262)948-5828 YES 04/10/1999 KENOSHA 22 11007800 ACUTE 520021 HSPLACU48 315 SOUTHEASTERN FROEDTERT SOUTH - FROEDTERT KENOSHA HOSPITAL 6308 EIGHTH AVE KENOSHA, WI 53143 SCHMIDT JR, RICHARD VENTURA, SUSAN VENTURA, SUSAN (262)656-2011 JUNE (262)653-5852 YES 07/01/1966 KENOSHA *Type is LTC or Hospital bt 14 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region 305 11007800 SATELLITE HSPSAT002 128 SOUTHEASTERN Name Address Administrator DON Sub Administrator County FROEDTERT SOUTH-FROEDTERT PLEASANT PRAIRIE HOSPITA SCHMIDT JR, RICHARD 9555 76TH ST WOHLGEMUTH, LINDA PLEASANT PRAIRIE, WI 53158 WOHLGEMUTH, LINDA Phone FY End Fax Accredited Participation Date (262)577-8000 JUNE (262)653-5852 YES KENOSHA 23 11012900 ACUTE 520087 HSPLACU49 325 GUNDERSEN LUTHERAN MEDICAL CENTER 1910 SOUTH AVE LA CROSSE, WI 54601 RATHGABER, SCOTT SMITH HOUSKAMP, BETH DOLAN, MICHAEL (608)782-7300 DECEMBER (608)775-9506 YES 07/01/1966 LA CROSSE 24 11006300 ACUTE 520004 HSPLACU33 331 MAYO CLINIC HEALTH SYSTEM-FRANCISCAN HEALTHCARE 700 WEST AVENUE SOUTH LA CROSSE, WI 54601 MUELLER, PAUL FRATZKE, JASON MUELLER, PAUL MORREY, MICHAEL LA CROSSE (608)785-0940 DECEMBER (608)392-9429 YES 07/01/1966 1015 11014800 CAH 521312 HSPLACU61 25 SOUTHERN MEMORIAL HOSPITAL OF LAFAYETTE COUNTY 800 CLAY ST DARLINGTON, WI 53530 KEUPERS, KATHLEEN VIETH, TERRI KEUPERS, KATHLEEN (608)776-4466 DECEMBER NO 04/01/2001 LAFAYETTE *Type is LTC or Hospital bt 15 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 1841354214 1055 CAH 521350 HSPLACU54 25 ASPIRUS LANGLADE HOSPITAL 112 E FIFTH AVE ANTIGO, WI 54409 BARTH, ANDREW BUNTEN, SHERRY TINCHER, PAT Phone FY End Fax Accredited Participation Date (715)623-2331 JUNE (715)623-9440 YES 02/01/2005 LANGLADE 1043 11007300 CAH 521339 HSPLACU38 25 ASCENSION GOOD SAMARITAN HOSPITAL 601 S CENTER AVE MERRILL, WI 54452 GAPKO, DAWN LEININGER, CHERYL LEININGER, CHERYL (715)536-5511 JUNE (715)539-2107 YES 07/01/2004 LINCOLN 1016 11000800 CAH 521313 HSPLACU80 18 NORTHERN ASCENSION SACRED HEART HOSPITAL 401 W MOHAWK DR SUITE 100 TOMAHAWK, WI 54487 OUNGST, LAURIE MATESZEWSKI, JONATHAN OUNGST, LAURIE (715)453-7700 JUNE (715)453-7716 NO 05/01/2001 LINCOLN 7 11014600 ACUTE 520107 HSPLACU44 167 NORTHEASTERN *Type is LTC or Hospital bt HOLY FAMILY MEMORIAL 2300 WESTERN AVE MANITOWOC, WI 54221 NORELL, BRETT DAY, TROY VEESER, THOMAS MANITOWOC (920)320-2011 DECEMBER (920)320-5129 YES 07/01/1966 16 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11008900 85 ACUTE 520034 HSPLACU126 69 NORTHEASTERN AURORA MEDICAL CTR MANITOWOC COUNTY 5000 MEMORIAL DRIVE TWO RIVERS, WI 54241 KOCOUREK, CATHIE RAMIREZ, JOLENE RAMIREZ, JOLENE Phone FY End Fax Accredited Participation Date (920)794-5000 DECEMBER (920)794-5487 YES 07/01/1966 MANITOWOC 188 11008500 ACUTE 520030 HSPLACU135 325 NORTHERN ASPIRUS WAUSAU HOSPITAL 333 PINE RIDGE BLVD WAUSAU, WI 54401 LENTZ, DARRELL HEYWOOD, MATT (715)847-2121 (715)847-2108 YES 07/01/1970 MARATHON 10063700 206 PSYCH 524017 HSPLPSY8 16 NORTHERN NORTH CENTRAL HEALTH CARE 1100 LAKEVIEW DR WAUSAU, WI 54403 LOY, MICHAEL LUCORE, PAT (715)848-4600 DECEMBER (715)848-2362 YES 01/31/1975 MARATHON 310 11024800 ACUTE 520202 HSPLACU150 99 NORTHERN *Type is LTC or Hospital bt ASCENSION ST CLARES HOSPITAL 3400 MINISTRY PARKWAY WESTON, WI 54476 STAMAS, PETER WEINFURTER, JO ANN WEINFURTER, JO ANN STAMAS, PETER MARATHON (715)393-3000 JUNE (715)359-1087 YES 12/05/2005 17 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11001400 155 ACUTE 520113 55 HSPLACU9 NORTHEASTERN AURORA MEDICAL CENTER BAY AREA 3003 UNIVERSITY DR MARINETTE, WI 54143 HARDING, EDWARD 320 ROGERS MEMORIAL HOSPITAL 4600 W SCHROEDER DRIVE BROWN DEER, WI 53223 MUELLER, PAUL MOLNAR-SMITH, KAREN MUELLER, PAUL SATELLITE HSPSAT017 56 VANCOURT, BERNADINE SWANSON, NICOLE MARINETTE Phone FY End Fax Accredited Participation Date (715)735-4200 DECEMBER (715)732-8208 YES 07/01/1966 (414)865-2500 YES MILWAUKEE 16 11017200 SATELLITE HSPSAT008 275 SOUTHEASTERN AURORA ST LUKES MED CTR SOUTH SHORE 5900 SOUTH LAKE DRIVE CUDAHY, WI 53110 BAUER, JESSICA HORNER, ANDREA POTTS, DENNIS (414)489-4000 DECEMBER YES MILWAUKEE 314 100000999 SATELLITE HSPSAT018 52 *Type is LTC or Hospital bt ASCENSION SE WISCONSIN HOSPITAL - FRANKLIN CAMPUS 10101 S 27TH ST FRANKLIN, WI 53132 MCMANMON, KRISTIN GANSEMER, SHEILA GANSEMER, SHEILA MCMANMON, KRISTIN MILWAUKEE (414)325-4500 JUNE (414)325-4511 YES 18 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 1861638971 1070 ACUTE 520205 HSPLACU993 16 SOUTHEASTERN MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL 10101 SOUTH 27TH ST 2ND FLOOR FRANKLIN, WI 53132 ANDERSEN, TRAVIS GANSEMER, SHEILA GANSEMER, SHEILA Phone FY End Fax Accredited Participation Date (414)817-5800 DECEMBER (414)325-4511 YES 08/19/2009 MILWAUKEE 1006 11023600 ACUTE 520194 HSPLACU140 30 ORTHOPAEDIC HOSPITAL OF WISCONSIN 475 W RIVER WOODS PKWY GLENDALE, WI 53212 CRAMER, BRIAN JOHNSON, NANETTE SPIESS, KIM (414)961-6800 DECEMBER (414)961-6778 NO 10/12/2001 MILWAUKEE 53 11010300 ACUTE 520051 HSPLACU113 432 SOUTHEASTERN ASCENSION COLUMBIA ST MARY'S HOSPITAL MILWAUKEE 2323 N LAKE DR MILWAUKEE, WI 53211 ELKINS, KELLY 165 11020000 REHAB 523025 HSPLACU81 31 SOUTHEASTERN ASCENSION SACRED HEART REHABILITATION HOSPITAL 2301 N LAKE DRIVE 8TH FLOOR MILWAUKEE, WI 53211 ELKINS, KELLY *Type is LTC or Hospital bt BRADLEY, CONNIE MALCOM, NATHANIEL BAUGHMAN, SHARON MILWAUKEE MALCOM, NATHANIEL BAUGHMAN, SHARON MILWAUKEE (414)585-1374 JUNE (414)585-1444 YES 07/01/1966 (414)585-1374 JUNE (414)585-1444 YES 07/01/1984 19 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11017100 30 ACUTE 520136 HSPLACU100 538 SOUTHEASTERN ASCENSION SE WISCONSIN HOSPITAL - ST JOSEPH CAMPUS 5000 W CHAMBERS ST MILWAUKEE, WI 53210 KLUESNER, KEVIN KOHOUT, MARY JO Phone FY End Fax Accredited Participation Date (414)447-2130 JUNE (414)874-4393 YES 07/01/1966 MILWAUKEE 75 11012400 ACUTE 520078 HSPLACU98 260 SOUTHEASTERN ASCENSION ST FRANCIS HOSPITAL 3237 S 16TH ST MILWAUKEE, WI 53215 BERG, JILL LEATHERMAN, ANDREW TRZNADEL, MARC (414)647-5000 JUNE (414)647-5565 YES 07/01/1966 MILWAUKEE 74 11017200 SATELLITE HSPSAT016 386 SOUTHEASTERN AURORA SINAI MEDICAL CENTER 945 N 12TH ST MILWAUKEE, WI 53233 BAUER, JESSICA HAYES, KEELEY POTTS, DENNIS (414)219-7290 DECEMBER (414)219-7402 YES MILWAUKEE 160 11017200 ACUTE 520138 HSPLACU108 938 SOUTHEASTERN AURORA ST LUKES MEDICAL CENTER 2900 W OKLAHOMA AVE MILWAUKEE, WI 53215 GOLANOWSKI, MARIE VOS, THERESA FRANCAVIGLIA, STEVE (414)649-6000 DECEMBER YES 07/01/1966 MILWAUKEE *Type is LTC or Hospital bt 20 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County (414)646-1865 (414)646-5452 NO 04/24/2009 AURORA ST LUKES MEDICAL CENTER 529801 WITH00233 Phone FY End Fax Accredited Participation Date TRANSPLANT 2900 W OKLAHOMA AVE 5TH FLOOR GALLERIA BUILDING MILWAUKEE, WI 53215 MILWAUKEE 11019700 135 CHILD 523300 HSPLACU19 298 SOUTHEASTERN CHILDRENS HOSPITAL OF WISCONSIN 9000 W WISCONSIN AVE MILWAUKEE, WI 53226 TROY, PEGGY KOROM, NANCY GORELICK, MARC TURNER, SCOTT MILWAUKEE (414)266-2000 (414)266-2307 NO 06/29/2010 CHILDRENS HOSPITAL OF WISCONSIN 529803 WITH00240 (414)266-2000 DECEMBER (414)266-2307 YES 01/01/1984 TRANSPLANT 9000 W WISCONSIN AVEUNE MILWAUKEE, WI 53226 MILWAUKEE 279 11000400 SATELLITE HSPSAT010 59 SOUTHEASTERN *Type is LTC or Hospital bt FROEDTERT MEMORIAL LUTHERAN HOSPITAL CHW 9200 W WISCONSIN AVE MILWAUKEE, WI 53226 BUCK, CATHERINE BECHTEL, KATHLEEN CONLEY, ERIC MILWAUKEE (414)805-3000 JUNE (414)805-7790 YES 21 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11000400 232 ACUTE 520177 HSPLACU35 724 SOUTHEASTERN FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 W WISCONSIN AVE MILWAUKEE, WI 53226 BUCK, CATHERINE BECHTEL, KATHLEEN CONLEY, ERIC MILWAUKEE (414)805-3000 JUNE (414)805-8910 YES 09/29/1980 (414)805-1979 (414)805-7790 NO 07/21/2010 FROEDTERT MEMORIAL LUTHERAN HOSPITAL 529804 WITH00234 Phone FY End Fax Accredited Participation Date TRANSPLANT 9200 W WISCONSIN AVE MILWAUKEE, WI 53226 MILWAUKEE 10062900 229 PSYCH 524001 HSPLPSY6 144 SOUTHEASTERN MILWAUKEE COUNTY BEHAVIORAL HEALTH DIVISION 9455 W WATERTOWN PLANK RD MILWAUKEE, WI 53226 LAPPEN, MICHAEL OCZUS, LINDA (414)257-5202 DECEMBER (414)257-8018 NO 07/01/1966 MILWAUKEE 304 11023200 SATELLITE HSPSAT011 29 SOUTHEASTERN SELECT SPEC HOSPITAL - ST FRANCIS 3237 S 16TH ST, 5TH FLOOR MILWAUKEE, WI 53215 MATTES, DENNIS REUTER, JENNIFER CANNON, MATT (414)649-6991 DECEMBER (414)649-5268 YES MILWAUKEE *Type is LTC or Hospital bt 22 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 10062800 164 PSYCH 524000 105 HSPLPSY7 SOUTHEASTERN AURORA PSYCHIATRIC HOSPITAL 1220 DEWEY AVE WAUWATOSA, WI 53213 CARLSON, PETER LEWISTON, JAMIE Phone FY End Fax Accredited Participation Date (414)454-6600 DECEMBER (414)454-6450 YES 07/01/1966 MILWAUKEE 149 11017300 ACUTE 520139 HSPLACU136 350 SOUTHEASTERN AURORA WEST ALLIS MEDICAL CENTER 8901 W LINCOLN AVE WEST ALLIS, WI 53227 KELLAR, RICHARD GIBBS, KAREN FRANCAVIGLIA, STEVE (414)328-6000 DECEMBER (414)328-8536 YES 07/01/1966 MILWAUKEE 751 10066300 SATELLITE HSPSAT012 81 SOUTHEASTERN ROGERS MEMORIAL HOSPITAL MILWAUKEE 11101 W LINCOLN AVE WEST ALLIS, WI 53227 MUELLER, PAUL HICKS, TERESA CRAWFORD, ANGIE (414)327-3000 (262)646-3158 YES MILWAUKEE 11023200 1002 LT 522006 HSPLACU85 34 SOUTHEASTERN SELECT SPECIALTY HOSPITAL MILWAUKEE 8901 W LINCOLN AVE 2ND FLOOR WEST ALLIS, WI 53227 MATTES, DENNIS REUTER, JENNIFER CANNON, MATT (414)328-7700 DECEMBER (414)328-7434 YES 10/31/1999 MILWAUKEE *Type is LTC or Hospital bt 23 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Administrator DON Sub Administrator County Lic # Vendor # Provider # Type* Fac# Beds Region Name Address 11015900 1009 CAH 521305 25 HSPLCRI2 SOUTHERN MAYO CLINIC HLTH SYSTM FRANCISCAN HLTHCARE SPARTA MEYER, TIA 310 W MAIN ST DOCKHAM, KIM SPARTA, WI 54656 KINNEY, MEGHAN Phone FY End Fax Accredited Participation Date (608)269-2132 DECEMBER (608)269-4562 YES 04/20/2000 MONROE 1023 11017800 CAH 521320 HSPLACU124 25 TOMAH MEMORIAL HOSPITAL 501 GOPHER DR TOMAH, WI 54660 STUART, PHILIP MYHRE, TRACY ZEPS, JOE (608)372-2181 SEPTEMBER (608)377-8720 YES 04/01/2002 MONROE 1012 11014100 CAH 521310 HSPLACU24 25 NORTHEASTERN HSHS ST CLARE MEMORIAL HOSPITAL 855 S MAIN ST OCONTO FALLS, WI 54154 PANDL, THERESE 1061 11024600 CAH 521356 HSPLCRI17 10 NORTHEASTERN BELLIN HEALTH OCONTO HOSPITAL 820 ARBUTUS AVE OCONTO, WI 54153 CORMIER, LAURA HIEB, LAURA CORMIER, LAURA BIEBER, JULIE OCONTO *Type is LTC or Hospital bt HAFEMAN, PAULA BRABANT, CHRISTOPHER OCONTO (920)846-3444 JUNE (920)846-8101 NO 02/01/2001 (920)835-1101 SEPTEMBER (920)516-7088 YES 11/18/2005 24 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11000700 138 ACUTE 520019 HSPLACU117 73 NORTHERN ASCENSION ST MARYS HOSPITAL 2251 NORTH SHORE DR RHINELANDER, WI 54501 OUNGST, LAURIE OUNGST, LAURIE OUNGST, LAURIE Phone FY End Fax Accredited Participation Date (715)361-2000 JUNE (715)361-4877 YES 07/01/1966 ONEIDA 201 11013300 ACUTE 520091 HSPLACU45 99 NORTHERN HOWARD YOUNG MEDICAL CTR 240 MAPLE ST WOODRUFF, WI 54568 OUNGST, LAURIE MONGE, JACQUI OUNGST, LAURIE MARTIN, SARAH ONEIDA (715)356-8000 SEPTEMBER (715)356-6097 YES 07/01/1966 88 11006700 ACUTE 520009 HSPLACU97 332 NORTHEASTERN ASCENSION NE WISCONSIN - ST ELIZABETH CAMPUS 1506 S ONEIDA ST APPLETON, WI 54915 HILT, MONICA KIRSCHLING, CRYSTAL DONATELLE, LAWRENCE HILT, MONICA OUTAGAMIE (920)738-2000 JUNE (920)831-8916 YES 07/01/1966 169 11019000 ACUTE 520160 HSPLACU3 160 NORTHEASTERN THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC 1818 N MEADE ST APPLETON, WI 54911 GISI, DALE (920)731-4101 DECEMBER (920)738-6319 YES 07/01/1966 THOMPSON, MARK OUTAGAMIE *Type is LTC or Hospital bt 25 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11010400 1029 CAH 521326 HSPLACU69 25 NORTHEASTERN THEDACARE MEDICAL CENTER NEW LONDON 1405 MILL ST NEW LONDON, WI 54961 CORSO, DAVID JAGLA, AMY CORSO, DAVID JAGLA, AMY OUTAGAMIE (920)531-2000 DECEMBER (920)531-2098 YES 01/01/2003 317 1265740195 ACUTE 520207 HSPLACU221 132 SOUTHEASTERN AURORA MEDICAL CENTER 975 PORT WASHINGTON ROAD GRAFTON, WI 53024 GRAEBNER, DAVID (262)329-1000 DECEMBER (262)329-1001 YES 12/20/2010 LESNIAK, JACKLYNN Phone FY End Fax Accredited Participation Date OZAUKEE 246 11008300 ACUTE 520027 HSPLACU114 182 SOUTHEASTERN ASCENSION COLUMBIA ST MARY'S HOSPITAL OZAUKEE 13111 N PORT WASHINGTON RD MEQUON, WI 53097 ELKINS, KELLY STREFF, SHARON (414)585-1374 JUNE (414)585-1444 YES 07/01/1966 OZAUKEE 1008 521307 HSPLCRI8 11000500 CAH 25 ADVENTHEALTH DURAND 1220 3RD AVE W DURAND, WI 54736 PETERSON, DOUGLAS JACOBSON, ANGELA (715)672-4211 DECEMBER NO 08/01/2000 PEPIN *Type is LTC or Hospital bt 26 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11006800 1054 CAH 521349 HSPLACU75 25 RIVER FALLS AREA HOSPITAL 1629 E DIVISION ST RIVER FALLS, WI 54022 STRIKE, HELEN LOESCH, JENNIFER CRAVEN, BRUCE Phone FY End Fax Accredited Participation Date (715)307-6000 DECEMBER (715)307-6030 YES 01/01/2005 PIERCE 1069 SATELLITE HSPSAT014 10 AMERY HOSPITAL & CLINIC BEHAVIORAL HEALTH CENTER 230 DERONDA STREET AMERY, WI 54001 RUDQUIST, DEBRA REED, SANDI REED, SANDI (715)268-0060 DECEMBER NO POLK 1010 521308 HSPLCRI10 11007600 CAH 25 AMERY HOSPITAL & CLINIC 265 GRIFFIN STREET EAST AMERY, WI 54001 RUDQUIST, DEBRA REED, SANDI SURA, PATRICK (715)268-0300 DECEMBER (715)268-0311 YES 11/02/2000 POLK 1021 11018800 CAH 521318 HSPLACU50 23 LADD MEMORIAL HOSPITAL 2600 65TH AVENUE OSCEOLA, WI 54020 FORGE, MATTHEW ZIMMER, RACHEL ERICSON, KIM (715)294-2111 DECEMBER (715)294-3694 NO 01/01/2002 POLK *Type is LTC or Hospital bt 27 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address 18416091952 ST CROIX REGIONAL MEDICAL CENTER 1041 CAH 521337 235 E STATE STREET SAINT CROIX FALLS, WI 54024 HSPLACU96 25 WESTERN Administrator DON Sub Administrator County DOBOSENSKI, DAVE JENSEN, LAURA JENSEN, LAURA Phone FY End Fax Accredited Participation Date (715)483-0556 JUNE (715)483-0295 NO 04/07/2004 POLK 146 11006100 ACUTE 520002 HSPLACU119 94 NORTHERN ASCENSION ST MICHAELS HOSPITAL 900 ILLINOIS AVE STEVENS POINT, WI 54481 HILT, MONICA SEKERKA, BETH HILT, MONICA (715)346-5000 SEPTEMBER (715)346-5088 YES 07/01/1966 PORTAGE 324 SATELLITE HSPSAT020 8 ASPIRUS STEVENS POINT HOSPITAL 5409 VERN HOLMES DR STEVENS POINT, WI 54482 LENTZ, DARRELL (715)342-1166 (715)342-1158 NO PORTAGE 11016700 1028 CAH 521325 HSPLACU30 25 NORTHERN *Type is LTC or Hospital bt FLAMBEAU HOSPITAL 98 SHERRY AVE PARK FALLS, WI 54552 BRAUN, JAMES SCHREIBER, ELIZABETH BRAUN, JAMES EATON-NYMAN, JANE PRICE (715)762-7500 JUNE (715)762-7518 NO 10/01/2002 28 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11010900 14 ACUTE 520059 HSPLACU59 123 SOUTHEASTERN AURORA MEDICAL CENTER BURLINGTON 252 MCHENRY ST BURLINGTON, WI 53105 MILLER, ROBERT KORTH, NANCY Phone FY End Fax Accredited Participation Date (262)767-6545 DECEMBER (262)767-6545 YES 07/01/1966 RACINE 123 11013700 ACUTE 520096 HSPLACU116 314 SOUTHEASTERN ASCENSION ALL SAINTS HOSPITAL 3801 SPRING ST RACINE, WI 53405 MCMANMON, KRISTIN LARAMIE, WAYNE MCMANMON, KRISTIN LARAMIE, WAYNE RACINE (262)687-4011 (262)687-8039 YES 07/01/1966 11013700 ASCENSION ALL SAINTS HOSPITAL 1320 WISCONSIN AVE RACINE, WI 53403 MCMANMON, KRISTIN LARAMIE, WAYNE MCMANMON, KRISTIN LARAMIE, WAYNE RACINE (262)687-2011 (262)687-8039 YES LAKEVIEW SPECIALTY HOSPITAL & REHAB CENTER 1701 SHARP ROAD WATERFORD, WI 53185 CASEY, NAHLA CASEY, NAHLA (262)534-7297 DECEMBER (262)534-7257 YES 10/01/1998 154 SATELLITE HSPSAT006 75 SOUTHEASTERN 11021300 272 LT 522005 HSPLACU53 39 SOUTHERN RACINE *Type is LTC or Hospital bt 29 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11015500 1045 CAH 521341 HSPLACU73 25 SOUTHERN RICHLAND HOSPITAL 333 E SECOND ST RICHLAND CENTER, WI 53581 ROESLER, BRUCE BURNLEY, CHARLES CHICKER, CINDY Phone FY End Fax Accredited Participation Date (608)647-6321 DECEMBER (608)647-6235 YES 07/08/2004 RICHLAND 67 11014000 ACUTE 520100 HSPLACU12 256 SOUTHERN BELOIT MEMORIAL HOSPITAL 1969 W HART RD BELOIT, WI 53511 MCKEVETT, TIM 1022 11008600 CAH 521319 HSPLACU56 16 SOUTHERN EDGERTON HOSPITAL AND HEALTH SERVICES 11101 N SHERMAN ROAD EDGERTON, WI 53534 SCHULTZ, JIM ALWIN-POPP, SUSAN ROEDER, CHARLES COX, SHARON KAPOOR, ROGER ROCK (608)364-5011 DECEMBER (608)364-5356 YES 07/01/1966 (608)884-3441 DECEMBER (608)561-6905 YES 01/01/2002 ROCK 162 11011400 ACUTE 520066 HSPLACU64 240 SOUTHERN MERCY HEALTH SYSTEM CORP 1000 MINERAL POINT AVE JANESVILLE, WI 53548 BEA, JAVON PEARSON, ELIZABETH (608)756-6080 JUNE (608)756-6168 YES 07/01/1966 ROCK *Type is LTC or Hospital bt 30 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 1194004408 318 ACUTE 520208 HSPLACU994 50 SOUTHERN SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE 3400 EAST RACINE STREET JANESVILLE, WI 53546 LAYMAN, BEN GLENN, KATHLEEN GLENN, KATHLEEN Phone FY End Fax Accredited Participation Date (608)373-8000 DECEMBER (608)373-8006 YES 01/30/2012 ROCK 1030 11009300 CAH 521328 HSPLACU78 25 MARSHFIELD MEDICAL CENTER - LADYSMITH 900 COLLEGE AVE WEST LADYSMITH, WI 54848 EUCLIDE, JEFF EUCLIDE, JEFF BOARD, PATRICK (715)532-5561 SEPTEMBER (715)389-3414 NO 03/01/2003 RUSK 1052 521347 HSPLACU7 11016100 CAH 25 WESTERN WISCONSIN HEALTH 1100 BERGSLIEN ST BALDWIN, WI 54002 PAGE, ALISON GINGERY, ADAM (715)684-1111 SEPTEMBER (715)684-1119 NO 10/01/2004 SAINT CROIX 1039 11018700 CAH 521335 HSPLACU46 25 HUDSON HOSPITAL & CLINIC 405 STAGELINE ROAD HUDSON, WI 54016 BOROWSKI, TOM YAEGER, KRISTY JOHNSON, DOUG (715)531-6000 DECEMBER (715)531-6011 YES 05/01/2004 SAINT CROIX *Type is LTC or Hospital bt 31 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11008200 1050 CAH 521345 HSPLACU43 25 WESTFIELDS HOSPITAL AND CLINIC 535 HOSPITAL RD NEW RICHMOND, WI 54017 MASSEY, STEVE SATHRE, HELEN JOHNSON, DOUG Phone FY End Fax Accredited Participation Date (715)243-2600 DECEMBER (715)243-2851 YES 08/01/2004 SAINT CROIX 65 11022800 ACUTE 520057 HSPLACU95 100 SOUTHERN SSM HEALTH ST CLARE HOSPITAL - BARABOO 707 14TH ST BARABOO, WI 53913 WALCZAK, LAURA WALCZAK, LAURA WYSOCKI, SCOTT CULOTTA, JENNIFER SAUK (608)356-1400 DECEMBER (608)356-1367 YES 07/01/1966 122 11013600 ACUTE 520095 HSPLACU84 36 SOUTHERN SAUK PRAIRIE HOSPITAL 260 26TH STREET PRAIRIE DU SAC, WI 53578 LERCH, SHAWN COLE-OUZOUNIAN, DENISE DREGNEY, JAMES (608)643-3311 DECEMBER (608)643-7680 YES 07/01/1966 SAUK 1057 11001500 CAH 521351 HSPLACU72 25 SOUTHERN REEDSBURG AREA MEDICAL CENTER 2000 N DEWEY AVE REEDSBURG, WI 53959 VAN MEETEREN, ROBERT OLSON, LINDA TURNER, DALE (608)524-6487 SEPTEMBER (608)524-6887 YES 01/01/2005 SAUK *Type is LTC or Hospital bt 32 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11001600 1040 CAH 521336 HSPLACU41 25 NORTHERN HAYWARD AREA MEMORIAL HOSPITAL 11040 N STATE RD 77 HAYWARD, WI 54843 BEIRL, LUKE ZELLER, BRAD Phone FY End Fax Accredited Participation Date (715)934-4321 MARCH (715)934-4270 NO 05/01/2004 SAWYER 1051 11013400 CAH 521346 HSPLACU86 25 NORTHEASTERN THEDACARE MEDICAL CENTER - SHAWANO INC 100 COUNTY RD B SHAWANO, WI 54166 CHIKOWSKI, JULIE BLOCK, PENNY (715)526-2111 DECEMBER (715)526-7205 YES 09/01/2004 SHAWANO 38 11009000 ACUTE 520035 HSPLACU87 185 NORTHEASTERN AURORA SHEBOYGAN MEMORIAL MEDICAL CTR 2629 N 7TH ST SHEBOYGAN, WI 53083 GRAEBNER, DAVID KNITT, LORI (920)451-5000 DECEMBER (920)451-5333 YES 07/01/1966 SHEBOYGAN 37 11009800 ACUTE 520044 HSPLACU120 185 NORTHEASTERN ST NICHOLAS HOSPITAL 3100 SUPERIOR AVE SHEBOYGAN, WI 53081 BAGNALL, ANDREW MARTIN, MARY (920)459-8300 JUNE (920)452-8336 YES 07/01/1966 SHEBOYGAN *Type is LTC or Hospital bt 33 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11006400 1027 CAH 521324 HSPLACU57 25 WESTERN ASPIRUS MEDFORD HOSPITAL & CLINICS, INC 135 S GIBSON ST MEDFORD, WI 54451 HUSTEDT, DALE LATO, BARBARA SHAW, GREG Phone FY End Fax Accredited Participation Date (715)748-8100 JUNE (715)748-8199 YES 06/10/2002 TAYLOR 1003 521302 HSPLCRI4 11015600 CAH 18 MAYO CLINIC HEALTH SYSTEM-OAKRIDGE 13025 8TH ST OSSEO, WI 54758 HELMERS, RICHARD OLSON, JAQUELINE (715)597-3121 DECEMBER (715)597-6250 YES 11/04/1999 TREMPEALEAU 1019 11016000 CAH 521316 HSPLACU125 25 GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS 18601 LINCOLN ST WHITEHALL, WI 54773 OLSON, JONI PIENTOK, LANA PIENTOK, LANA (715)538-4361 DECEMBER (715)538-2271 NO 09/23/2001 TREMPEALEAU 1005 11007400 CAH 521304 HSPLCRI6 25 SOUTHERN GUNDERSEN ST JOSEPHS HOSPITAL AND CLINICS 400 WATER AVE HILLSBORO, WI 54634 MCCOIC, KRISTIE TENGBLAD, TONI MCCOIC, KRISTIE (608)489-8000 DECEMBER (608)489-8181 NO 03/08/2000 VERNON *Type is LTC or Hospital bt 34 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 1100800 1053 CAH 521348 HSPLACU130 25 WESTERN VERNON MEMORIAL HOSPITAL 507 SOUTH MAIN ST VIROQUA, WI 54665 HARTBERG, DAVID TRAYNOR, KAREN Phone FY End Fax Accredited Participation Date (608)637-2101 SEPTEMBER (608)637-2141 NO 10/19/2004 VERNON 1000 11018900 CAH 521300 HSPLCRI1 25 NORTHERN ASCENSION EAGLE RIVER HOSPITAL 201 HOSPITAL ROAD EAGLE RIVER, WI 54521 OUNGST, LAURIE WILSON, CATE OUNGST, LAURIE WILSON, CATHERINE VILAS (715)479-7411 JUNE (715)356-6097 NO 10/01/1999 132 11021600 ACUTE 520102 HSPLACU51 109 SOUTHEASTERN AURORA LAKELAND MEDICAL CENTER W3985 COUNTY ROAD NN ELKHORN, WI 53121 MILLER, ROBERT KORTH, NANCY (262)741-2000 DECEMBER (262)741-2180 YES 07/01/1966 WALWORTH 1062 11024900 CAH 521357 HSPLCRI18 25 SOUTHEASTERN MERCY WALWORTH HOSPITAL & MEDICAL CENTER N2950 STATE ROAD 67 LAKE GENEVA, WI 53147 BEA, JAVON OLESTON, CARYN HALLATT, JENI (262)245-0535 JUNE (262)245-2198 YES 12/29/2005 WALWORTH *Type is LTC or Hospital bt 35 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11017000 1047 CAH 521342 HSPLACU47 25 INDIANHEAD MEDICAL CENTER SHELL LAKE 113 4TH AVE SHELL LAKE, WI 54871 JACK, SHANNON PANK, ANGELA PANK, ANGELA Phone FY End Fax Accredited Participation Date (715)468-7833 DECEMBER (715)468-7303 YES 10/01/2004 WASHBURN 1036 11010000 CAH 521332 HSPLACU91 25 SPOONER HEALTH SYSTEM 1280 CHANDLER DR SPOONER, WI 54801 SCHAFER, MICHAEL MILLER, CLINT BUSCH, REBECCA (715)635-2111 MARCH (715)939-1555 NO 02/12/2004 WASHBURN 195 11009200 ACUTE 520038 HSPLACU40 71 SOUTHEASTERN AURORA MEDICAL CTR WASHINGTON COUNTY 1032 E SUMNER ST HARTFORD, WI 53027 GRAEBNER, DAVID BIALAS, KAREN (262)673-2300 DECEMBER YES 07/14/1971 WASHINGTON 44 11011200 ACUTE 520063 HSPLACU99 70 SOUTHEASTERN FROEDTERT WEST BEND HOSPITAL 3200 PLEASANT VALLEY ROAD WEST BEND, WI 53095 ERICSON, ALLEN WAALA, SHELLY (262)334-5533 JUNE (262)836-7118 YES 07/01/1966 WASHINGTON *Type is LTC or Hospital bt 36 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region 262 11019400 SATELLITE HSPSAT007 175 SOUTHEASTERN Name Address Administrator DON Sub Administrator County ASCENSION SE WISCONSIN HOSPITAL - ELMBROOK CAMPUS RICHMAN, TIM 19333 W NORTH AVE KOHOUT, MARY JO BROOKFIELD, WI 53045 HASSAN, MUSHIR Phone FY End Fax Accredited Participation Date (262)785-2000 JUNE (262)785-2485 YES WAUKESHA 28 11014300 ACUTE 520103 HSPLACU25 237 SOUTHEASTERN FROEDTERT MENOMONEE FALLS HOSPITAL W180 N8085 TOWN HALL RD MENOMONEE FALLS, WI 53051 LUX, TERI WAALA, SHELLY ERICSON, ALLEN (262)251-1000 JUNE (262)253-7169 YES 07/01/1966 WAUKESHA 113 11011100 ACUTE 520062 HSPLACU58 156 SOUTHEASTERN OCONOMOWOC MEMORIAL HOSPITAL 791 E SUMMIT AVE OCONOMOWOC, WI 53066 190 0063800 PSYCH 524018 HSPLPSY11 90 SOUTHEASTERN ROGERS MEMORIAL HOSPITAL 34700 VALLEY RD OCONOMOWOC, WI 53066 EDWARDS, SUSAN MAY, JOHN PFITZINGER, MARGARET WAUKESHA MUELLER, PAUL COHN, TERRI EFFERTZ, KIMBERLY (262)569-9400 SEPTEMBER (262)928-4032 YES 07/01/1966 (262)646-4411 JUNE (262)646-3158 YES 03/24/1975 WAUKESHA *Type is LTC or Hospital bt 37 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 100009852 316 ACUTE 520206 HSPLACU220 117 SOUTHEASTERN AURORA MEDICAL CENTER SUMMIT 36500 AURORA DRIVE SUMMIT, WI 53066 BERGMANN, MICHAEL Phone FY End Fax Accredited Participation Date (262)434-1000 DECEMBER (262)434-1221 YES 05/03/2010 WAUKESHA 315 1417120197 REHAB 523027 HSPLRHB02 40 REHABILITATION HOSPITAL OF WISCONSIN 1625 COLD WATER CREEK DRIVE WAUKESHA, WI 53188 ANDERSON, BRADLEY PLANTE, VANESSA ANDERSON, BRADLEY MOLL, JASON WAUKESHA (262)521-8800 DECEMBER (262)521-8876 YES 11/12/2008 218 10063300 PSYCH 524026 HSPLPSY12 28 SOUTHEASTERN WAUKESHA COUNTY MENTAL HEALTH CTR 1501 AIRPORT RD WAUKESHA, WI 53188 LEWIS, JEFF BOYD, CRYSTAL BOYD, CRYSTAL (262)548-7950 DECEMBER (262)896-8046 NO 06/05/1979 WAUKESHA 41 11006600 ACUTE 520008 HSPLACU133 400 SOUTHEASTERN *Type is LTC or Hospital bt WAUKESHA MEMORIAL HOSPITAL 725 AMERICAN AVE WAUKESHA, WI 53188 EDWARDS, SUSAN MAY, JOHN PFITZINGER, MARGARET WAUKESHA (262)928-1000 SEPTEMBER (262)928-4032 YES 07/01/1966 38 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 11018600 1038 CAH 521334 HSPLACU76 25 NORTHEASTERN THEDACARE MEDICAL CENTER - WAUPACA INC 800 RIVERSIDE DRIVE WAUPACA, WI 54981 CORSO, DAVID CUFF, HEIDI CUFF, HEIDI CORSO, DAVID WAUPACA (715)258-1000 DECEMBER (715)258-1009 YES 03/06/2004 1004 11018200 CAH 521303 HSPLCRI5 25 NORTHEASTERN THEDACARE MEDICAL CENTER - WILD ROSE INC 601 GROVE AVE WILD ROSE, WI 54984 BENDING, TAMMY SIGOURNEY, JENNIFER BENDING, TAMMY SIGOURNEY, JENNIFER WAUSHARA (920)622-3257 DECEMBER (920)622-6020 NO 12/01/1999 1005 11023400 CHILD 523302 HSPLACU138 42 NORTHEASTERN CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY 130 SECOND ST NEENAH, WI 54956 TROY, PEGGY KOROM, NANCY TURNER, SCOTT (920)969-7900 DECEMBER (414)266-2307 YES 03/14/2001 Phone FY End Fax Accredited Participation Date WINNEBAGO 32 11009900 ACUTE 520045 HSPLACU123 182 NORTHEASTERN THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC 130 2ND ST NEENAH, WI 54956 GISI, DALE BLOCK, PENNY THOMPSON, MARK (920)729-3100 DECEMBER (920)729-3167 YES 07/01/1966 WINNEBAGO *Type is LTC or Hospital bt 39 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region 186 11010100 SATELLITE HSPSAT019 157 Name Address Administrator DON Sub Administrator County Phone FY End Fax Accredited Participation Date ASCENSION NE WISCONSIN-MERCY CAMPUS 500 S OAKWOOD RD OSHKOSH, WI 54904 HILT, MONICA KIRSCHLING, CRYSTAL HILT, MONICA (920)223-2000 JUNE (920)223-0508 YES WINNEBAGO 307 11024300 ACUTE 520198 HSPLACU148 84 NORTHEASTERN AURORA MEDICAL CTR OSHKOSH 855 N WESTHAVEN DRIVE OSHKOSH, WI 54904 NEWMAN, JOHN CARTER, SHANE CARTER, SHANE (920)456-6000 DECEMBER (920)456-7601 YES 12/06/2003 WINNEBAGO 250 10063000 PSYCH 524002 HSPLPSY13 335 NORTHEASTERN WINNEBAGO MENTAL HEALTH INSTITUTE 4100 TREFFERT DR WINNEBAGO, WI 54985 ANDREWS, JESSICA MONROE, LORI CRAGGS, CHRIS (920)235-4910 JUNE (920)237-2043 YES 07/01/1966 WINNEBAGO 51 11009100 ACUTE 520037 HSPLACU102 504 NORTHERN *Type is LTC or Hospital bt MARSHFIELD MEDICAL CENTER 611 ST JOSEPH AVE MARSHFIELD, WI 54449 BOARD, PATRICK HOERNEMAN, BRIAN BOARD, PATRICK WOOD (715)387-7850 SEPTEMBER (715)387-8601 YES 07/01/1966 40 Department of Health Services Division of Quality Assurance 05/01/2020 Hospitals Provider Directory for Wisconsin Listed in Order of County then City Lic # Vendor # Provider # Type* Fac# Beds Region Name Address Administrator DON Sub Administrator County 10063900 211 PSYCH 524019 16 HSPLPSY9 NORTHERN NORWOOD HEALTH CENTER 1600 N CHESTNUT AVE MARSHFIELD, WI 54449 BRUCE, JORDON MASANZ, ELIZABETH MASANZ, ELIZABETH Phone FY End Fax Accredited Participation Date (715)384-2188 DECEMBER (715)387-1533 NO 07/15/1975 WOOD 11 11008800 ACUTE 520033 HSPLACU77 99 NORTHERN ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY ST WISCONSIN RAPIDS, WI 54495 BARTH, ANDREW JOHNSON, KIMBERLY (715)423-6060 JUNE (715)421-7512 YES 07/01/1966 WOOD Count of providers: 162 *Type is LTC or Hospital bt Count of Accredited: 128 Count of Unaccredited: 34 41