Division of Quality AssuranceWisconsin Department of Health Services Page 1

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

124 BAY RIDGE LNBURLINGTON WI 53105(262) 767-2155 ANNE & RUSSELL LOETHERCounty: RACINE

BAY RIDGE HOME LLC

1222 LAUREL LNKANSASVILLE WI 53139

Type: Class:

Low/High rate:

AFH(262) 210-2230ANNE LOETHER

3,000/6,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 12/08/2006

BAY RIDGE HOME (0011733)

11/30/2018License Renewal Fee Due*:

2910 S BROWNS LAKE ROADBURLINGTON WI 53105

GERALD REINEKECounty: RACINE

REINEKE CARE HOMES, LLC

2940 MEALY ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 210-1371BONNIE REINEKE

4,660/6,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/05/2015

BROWNS LAKE HOME (0015553)

02/28/2019License Renewal Fee Due*:

316 S PERKINSBURLINGTON WI 53105(262) 909-4344 JEFFREY CRABTREECounty: RACINE

CRABTREE RESIDENTIAL LIVING INC

PO BOX 580393PLEASANT PRAIRIE WI 53158

Type: Class:

Low/High rate:

AFH(262) 909-4344JEFFREY CRABTREE

4,500/6,000M - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 08/30/2007

CEDAR HOME (0012080)

08/31/2019License Renewal Fee Due*:

141 DAVIDSON DRBURLINGTON WI 53105(262) 661-4585 ANNE LOETHERCounty: RACINE

BAY RIDGE HOME LLC

1222 LAUREL LNKANSASVILLE WI 53139

Type: Class:

Low/High rate:

AFH(262) 210-2230ANNE LOETHER

3,038/3,813M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 07/18/2012

CHICORY HOME (0014251)

06/30/2020License Renewal Fee Due*:

208 EDWARDS STBURLINGTON WI 53105(262) 909-4344 JEFF CRABTREECounty: RACINE

CRABTREE RESIDENTIAL LIVING

P O BOX 580393PLEASANT PRAIRIE WI 53158

Type: Class:

Low/High rate:

AFH(262) 909-4344JEFF CRABTEEE

4,500/5,500M - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/22/2010

CYPRESS HOME (0013354)

11/30/2018License Renewal Fee Due*:

506A STEPHANIE STREETBURLINGTON WI 53105(262) 895-6666 MELINDA J DOLPHINCounty: RACINE

DOLPHIN HOUSE A LLC

4525 GUNDERSON ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 895-6666MELINDA J DOLPHIN

5,500/7,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILL

Gender - Capacity:

Initial License: 11/10/2014

DOLPHIN HOUSE A LLC (0015101)

10/31/2018License Renewal Fee Due*:

506B STEPHANIE STREETBURLINGTON WI 53105(262) 895-6666 MELINDA DOLPHINCounty: RACINE

DOLPHIN HOUSE B LLC

4525 GUNDERSON ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 895-6666MELINDA J DOLPHIN

5,500/7,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILL

Gender - Capacity:

Initial License: 11/10/2014

DOLPHIN HOUSE B LLC (0015100)

10/31/2018License Renewal Fee Due*:

8339 B FISHMAN RDBURLINGTON WI 53105(262) 492-0179 MACK CRABTREECounty: RACINE

CRABTREE RESIDENTIAL LIVING INC

PO BOX 580393PLEASANT PRAIRIE WI 53158

Type: Class:

Low/High rate:

AFH(262) 909-4344JEFFREY CRABTREE

4,500/7,200M - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 12/03/2009

ELM HOME (0012870)

11/30/2019License Renewal Fee Due*:

1315 SCHNEIDER LNBURLINGTON WI 53105(262) 534-4018 RENEE GALLCounty: RACINE

GALL FAMILY CARE HOME

1315 SCHNEIDER LNBURLINGTON WI 53105

Type: Class:

Low/High rate:

AFH(262) 534-4018RENEE GALL

1,800/3,500M/F - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 02/23/2000

GALL FAMILY CARE HOME (0008955)

02/28/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 2

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

901 CRESTWOOD DRBURLINGTON WI 53105(262) 210-2230 ANNE LOETHERCounty: RACINE

BAY RIDGE HOME LLC

1222 LAUREL LNKANSASVILLE WI 53139

Type: Class:

Low/High rate:

AFH(262) 210-2230ANNE LOETHER

3,800/6,800F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 11/26/2008

JOAN STREET (0012616)

11/30/2018License Renewal Fee Due*:

8339 A FISHMAN RDBURLINGTON WI 53105(262) 492-0179 MACK CRABTREECounty: RACINE

CRABTREE RESIDENTIAL LIVING INC

PO BOX 580393PLEASANT PRAIRIE WI 53158

Type: Class:

Low/High rate:

AFH(262) 909-4344JEFFREY CRABTREE

4,500/7,200M - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 08/06/2009

MAPLE HOME (0012871)

07/31/2019License Renewal Fee Due*:

535 PARK AVENUEBURLINGTON WI 53105(262) 534-3467 GERALD REINEKECounty: RACINE

REINEKE CARE HOMES LLC

2940 MEALY RDWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 534-3467BONNIE REINEKE

3,800/6,200M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/16/2016

PARK HOUSE (0016160)

06/30/2020License Renewal Fee Due*:

584 EDGEWOOD AVEBURLINGTON WI 53105(262) 534-3467 GERALD REINEKECounty: RACINE

REINEKE CARE HOMES LLC

2940 MEALY RDWATERFORD WI 53105

Type: Class:

Low/High rate:

AFH(262) 534-3467GERALD REINEKE

3,334/4,728M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 04/14/2009

REINEKE CARE HOMES ROCHESTER HOME (0012796)

03/31/2019License Renewal Fee Due*:

32715 VISTA VIEW DRBURLINGTON WI 53105(262) 534-3338 SHARON SETTERMANCounty: RACINE

SHARON SETTERMAN

32715 VISTA VIEW DRBURLINGTON WI 53105

Type: Class:

Low/High rate:

AFH(262) 534-3338SHARON SETTERMAN

2,500/3,500M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/23/2003

SETTERMAN HOME (0010210)

10/31/2019License Renewal Fee Due*:

848 WEILER RDBURLINGTON WI 53105(262) 661-4008 ANNE LOETHERCounty: RACINE

BAY RIDGE HOME LLC

1222 LAUREL LNKANSASVILLE WI 53139

Type: Class:

Low/High rate:

AFH(262) 661-4008ANNE LOETHER

3,100/4,650M - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 11/16/2011

WEILER HOME (0013960)

10/31/2019License Renewal Fee Due*:

316 GARFIELD STBURLINGTON WI 53105(262) 806-7252 ELIZABETH BALLCounty: RACINE

WILLOW RUN FAMILY GROUP HOME INC

104 CLARK STBURLINGTON WI 53105

Type: Class:

Low/High rate:

AFH(262) 806-7252THOR CHRISTIANSEN

3,920/4,340M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/25/2012

WILLOW RUN 3 (0013991)

12/31/2019License Renewal Fee Due*:

104 CLARK STBURLINGTON WI 53105(262) 806-7252 ELIZABETH BALLCounty: RACINE

WILLOW RUN ADULT FAMILY GROUP HOME INC

104 CLARK STBURLINGTON WI 53105

Type: Class:

Low/High rate:

AFH(262) 806-7252THOR CHRISTIANSEN

2,865/3,172M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESS

Gender - Capacity:

Initial License: 11/01/1998

WILLOW RUN ADULT FAMILY GROUP HOME (390235)

10/31/2018License Renewal Fee Due*:

2125 PARKWAY DRCALEDONIA WI 53108(262) 681-7868 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

5,010/5,010M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/15/2001

ALPHA HOMES OF WISCONSIN XV (0009193)

06/30/2019License Renewal Fee Due*:

13207 HWY GCALEDONIA WI 53108(262) 878-3982 ANN HEDRINGTONCounty: RACINE

COUNTRY MEADOWS FAMILY CARE, LLC

2824 65TH DRIVEFRANKSVILLE WI 53126

Type: Class:

Low/High rate:

AFH(414) 397-9425ANN HEDRINGTON

4,235/5,245M/F - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 03/20/2014

COUNTRY MEADOWS FAMILY CARE ANGEL HOUSE (00149

02/28/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 3

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

2422 MARSHALL SQUAREDOVER WI 53139(262) 989-1898 PENNY ADOLPHCounty: RACINE

1014 VINE STUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(262) 939-3443DUSTIN SVENDSEN

3,000/7,500M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 06/13/2016

JAMES CARES LLC (0016153)

05/31/2020License Renewal Fee Due*:

21021 DURANDDOVER WI 53139(262) 878-9027 DR WILLIAM AMSTUTZCounty: RACINE

SHEPHERDS BAPTIST MINISTRIES INC

1805 15TH AVENUEUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(262) 878-5620MICHELE MCGRRY

4,900/4,900F - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 06/22/2016

SHEPHERDS MINISTRIES KUHNLE HOUSE (0016123)

06/30/2020License Renewal Fee Due*:

4430 HIGHWAY 38FRANKSVILLE WI 53126(414) 336-5639 VERNITA M WILLISCounty: RACINE

BOULDER CREEK LLC

10125 S 52ND STREETFRANKLIN WI 53132

Type: Class:

Low/High rate:

AFH(414) 498-6119PAT LARRABEE

4,310/19,500M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/30/2017

BOULDER CREEK HOUSE I (0016449)

03/31/2019License Renewal Fee Due*:

2824 65TH DRFRANKSVILLE WI 53126(262) 397-9425 ANN HEDRINGTONCounty: RACINE

ANN HEDRINGTON

18012 65TH CTFRANKSVILLE WI 53126

Type: Class:

Low/High rate:

AFH(262) 878-1018ANN HEDRINGTON

3,994/4,127M/F - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 12/17/2009

COUNTRY MEADOWS FAMILY CARE LLC (0013085)

12/31/2018License Renewal Fee Due*:

6810 HOODS CREEK ROADFRANKSVILLE WI 53126(414) 336-5639 VERNITA M WILLSCounty: RACINE

BOULDER CREEK LLC

10125 S 52ND STREETFRANKLIN WI 53132

Type: Class:

Low/High rate:

AFH(414) 498-6119PAT LARRABEE

4,310/19,500M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/22/2017

HOODS CREEK HOUSE I (0016525)

06/30/2019License Renewal Fee Due*:

21404 WASHINGTON AVEKANSASVILLE WI 53139(262) 895-6666 MELINDA DOLPHINCounty: RACINE

DOLPHIN MANOR LLC

4525 GUNDERSON ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 895-6666MELINDA DOLPHIN

5,000/6,000M/F - 4

ADVANCED AGEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILL

Gender - Capacity:

Initial License: 07/11/2007

DOLPHIN MANOR LLC (0011934)

06/30/2019License Renewal Fee Due*:

2720 MARSHALL SQUAREKANSASVILLE WI 53139

PENNY ADOLPHCounty: RACINE

JAMES CARES LLC

1014 VINE STUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(262) 939-3443DUSTIN SVENDSEN

133/4,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/24/2018

EAGLE LAKE MANOR (0017036)

05/31/2020License Renewal Fee Due*:

707 224TH AVEKANSASVILLE WI 53139(262) 878-0810 GLENN GUNDERSONCounty: RACINE

GUNDERSON FAMILY HOME

707 224TH AVEKANSASVILLE WI 53139

Type: Class:

Low/High rate:

AFH(262) 878-0810GLENN & KATHY GUNDERSON

5,200/9,000M/F - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 04/01/1998

GUNDERSON FAMILY HOME (390164)

03/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 4

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

24710 18TH STKANSASVILLE WI 53139(414) 847-1515 ELIZABETH MEYERCounty: RACINE

VOLUNTEERS OF AMERICA WISCONSIN INC

1661 N WATER ST #401MILWAUKEE WI 53202

Type: Class:

Low/High rate:

AFH(414) 847-1515ANNE FOERSTER

7,500/9,000M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESS

Gender - Capacity:

Initial License: 02/09/2011

KANSASVILLE HOUSE (0013507)

01/31/2019License Renewal Fee Due*:

1222 LAUREL LNKANSASVILLE WI 53139(262) 878-0185 ANNE & RUSSELL LOETHERCounty: RACINE

1222 LAUREL LNKANSASVILLE WI 53139

Type: Class:

Low/High rate:

AFH(262) 878-0185ANNE & RUSSELL LOETHER

2,281/3,750M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 05/19/2004

LOETHERS HOME (0010474)

05/31/2020License Renewal Fee Due*:

3820 29TH STKENOSHA WI 53144(262) 551-0495 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

5,510/5,510M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/03/2005

ALPHA HOMES OF WISCONSIN XVI (0010519)

02/28/2019License Renewal Fee Due*:

3945 JACOB CTMOUNT PLEASANT WI 53403(262) 989-7124 RODERICK F EVANSCounty: RACINE

BEACON OF HOPE RESIDENTIAL CARE

3945 JACOB CTMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(262) 989-7124RODERICK F EVANS

4,057/8,113M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/25/2012

BEACON OF HOPE ADULT FAMILY HOME (0014258)

06/30/2020License Renewal Fee Due*:

3820 ROYAL OAKS DRMOUNT PLEASANT WI 53406(262) 554-8022 MARSHA HARRINGTONCounty: RACINE

MARSHA HARRINGTON

PO BOX 081464RACINE WI 53408-1464

Type: Class:

Low/High rate:

AFH(262) 554-8022MARSHA HARRINGTON

4,197/7,969M/F - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 01/21/2003

CARE HOME (0009850)

01/31/2019License Renewal Fee Due*:

4945 CUMBERLAND ROADMOUNT PLEASANT WI 53405(262) 989-2366 GAYLE L MILLISCounty: RACINE

A CLEARER VISION LLC DBA ELIANNA HOMES V

3260 E CAROLLTON DRIVEOAK CREEK WI 53154

Type: Class:

Low/High rate:

AFH(262) 989-2366GAYLE L MILLIS

5,600/6,400M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/05/2017

ELIANA HOMES CUMBERLAND PLACE AFH (0016651)

06/30/2019License Renewal Fee Due*:

1111 N GREEN BAY RDMOUNT PLEASANT WI 53406(262) 880-1873 COURTNEY CONNERCounty: RACINE

GREEN BAY ADULT FAMILY HOME

PO BOX 44375RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-1873COURTNEY CONNER

6,000/M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/31/2016

GREEN BAY ADULT FAMILY HOME (0016128)

05/31/2020License Renewal Fee Due*:

448 NEWMAN RDMOUNT PLEASANT WI 53406(414) 687-2088 ANN CIOMBORCounty: RACINE

HARMONY HOME ON NEWMAN LLC

2400 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(414) 687-2088ANN CIOMBOR

6,000/M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/20/2017

HARMONY HOME ON NEWMAN LLC (0016680)

07/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 5

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1114 N HILLOCK DRIVEMOUNT PLEASANT WI 53406(262) 744-4844 INDIGO HARRISCounty: RACINE

J HARRIS HOMES INC

1114 N HILLOCK DRIVEMOUNT PLEASANT WI 53406

Type: Class:

Low/High rate:

AFH(262) 744-4544INDIGO HARRIS

3,750/4,750M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 08/29/2017

J HARRIS HOMES (0016712)

08/31/2019License Renewal Fee Due*:

3824 DAISY LANEMOUNT PLEASANT WI 53403(262) 456-2459 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

6,975M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 07/19/2017

OPEN ARMS 20 LLC (0016790)

07/31/2019License Renewal Fee Due*:

4406 WOOD RDMOUNT PLEASANT WI 53403(262) 880-1873 COURTNEY CONNERCounty: RACINE

WOOD ADULT FAMILY HOME, LLC

PO BOX 44375RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-1873COURTNEY CONNER

6,000/M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/10/2017

WOOD ADULT FAMILY HOME LLC (0016414)

12/31/2018License Renewal Fee Due*:

4604 SPRING STREETMT PLEASANT WI 53405(262) 633-4103 PRISCELLA K WHITECounty: RACINE

ABOVE & BEYOND ADULT FAMILY HOME LLC

5801 WASHINGTON AVE SUITE 205MT PLEASANT WI 53406

Type: Class:

Low/High rate:

AFH(262) 417-2796PRISCELLA WHITE

6,000/10,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/10/2013

ABOVE & BEYOND AFH III (0014601)

05/31/2019License Renewal Fee Due*:

2037 N GREEN BAY RDMT PLEASANT WI 53405(312) 694-3654 WALID ABUGHRINCounty: RACINE

BALANCE LIVING CENTER

2037 N GREEN BAY RDMOUNT PLEASANT WI 53405

Type: Class:

Low/High rate:

AFH(312) 694-3654WALID ABUGHRIN

5,400/20,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 01/17/2017

BALANCE LIVING CENTER (0016261)

12/31/2018License Renewal Fee Due*:

6437 DURAND AVEMT PLEASANT WI 53406(262) 000-0000 PARIT PATELCounty: RACINE

DURAND ADULT FAMILY HOME II LLC

2054 KEARNEY AVENUERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 939-3666PARIT PATEL

6,500/8,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 08/05/2014

DURAND ADULT FAMILY HOME II LLC (0015129)

07/31/2020License Renewal Fee Due*:

6439 DURAND AVENUEMT PLEASANT WI 53406(262) 939-3666 PARIT PATELCounty: RACINE

DURAND ADULT FAMILY HOME, LLC

2054 KEARNEY AVENUERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 939-3666PARIT PATEL

6,500/8,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 01/28/2014

DURAND ADULT FAMILY HOME LLC (0014928)

01/31/2019License Renewal Fee Due*:

3725 SHERRIE LNMT PLEASANT WI 53405(262) 456-2459 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

5,999M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/15/2016

OPEN ARMS 20 LLC (0016272)

08/31/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 6

06/25/2018Directory U d t d

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By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

5335 TAYLOR AVEMT PLEASANT WI 53403(262) 456-2459 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS ASSISTED LIVING LLC

5335 TAYLOR AVEMT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

3,500/5,999M/F - 4

ADVANCED AGEDPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 10/21/2015

OPEN ARMS 20 LLC (0015801)

06/30/2019License Renewal Fee Due*:

3341 HAMLINRACINE WI 53403(262) 676-9756 RHONDA GRIFFINCounty: RACINE

1ST CHOICE ADULT FAMILY

1536 TAYLOR AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 822-1625RHONDA GRIFFIN

3,000/5,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/28/2016

1ST CHOICE ADULT FAMILY (0015993)

11/30/2018License Renewal Fee Due*:

3337 CHARLES STREETRACINE WI 53402(262) 456-2821 DESIREE VEASEYCounty: RACINE

A GOLDEN STAR AFH LLC

2052 THURSTON AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 412-4264VALERIE KING

6,500/9,000M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/23/2017

A GOLDEN STAR AFH (0016654)

05/31/2019License Renewal Fee Due*:

1638 ERIE STRACINE WI 53402(262) 456-2821 DESIREE VEASEYCounty: RACINE

A GOLDEN STAR AFH LLC

4201 MONTEREY DRRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 412-4274DESIREE VEASEY

6,500/9,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/13/2018

A GOLDEN STAR AFH III (0017075)

02/29/2020License Renewal Fee Due*:

2052 THURSTON AVERACINE WI 53403(262) 412-4274 DESIREE VEASEYCounty: RACINE

A GOLDEN STAR AFH LLC

2052 THURSTON AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 412-4274VALERIE KING

6,000/9,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/06/2016

A GOLDEN STAR AFH LLC (0016212)

08/31/2018License Renewal Fee Due*:

1341 VIRGINIA STRACINE WI 53403(262) 939-3666 PARIT PATELCounty: RACINE

A LOVING CARE GROUP HOMES LLC

2054 KEARNEY AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 939-3666PARIT PATEL

7,750/12,400M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 01/07/2013

A LOVING CARE GROUP HOMES II LLC (0014287)

12/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 7

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

2710 WESTLAWN AVERACINE WI 53405(262) 939-3666 PARIT PATELCounty: RACINE

A LOVING CARE GROUP HOMES LLC

2054 KEARNEY AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 633-4977PARIT PATEL

7,750/12,400M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 02/16/2011

A LOVING CARE GROUP HOMES LLC (0013619)

01/31/2019License Renewal Fee Due*:

901 OSTERGAARD AVERACINE WI 53406(262) 752-3830 CHANEL NELSONCounty: RACINE

NATURALLY NURTURED LLC

1430 VILLA STRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 752-3830CHANEL NELSON

3,500/10,500M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/01/2015

A NATURALLY NURTURING PLACE (0015742)

08/31/2019License Renewal Fee Due*:

2111 MOUNT PLEASANT STREETRACINE WI 53404(262) 412-3269 MIRANDA YOUNGCounty: RACINE

A+ JUST LIKE FAMILY LLC

620 SILENT SUNDAYRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 412-3269MIRANDA YOUNG

2,800/10,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILL

Gender - Capacity:

Initial License: 06/05/2013

A+ JUST LIKE FAMILY 2 LLC (0014635)

05/31/2019License Renewal Fee Due*:

1108 ILLINOIS STRACINE WI 53405(262) 412-3269 MIRANDA YOUNGCounty: RACINE

A+ JUST LIKE FAMILY LLC

620 SILENT SUNDAY CTRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 412-3269MIRANDA YOUNG

3,800/8,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/11/2018

A+ JUST LIKE FAMILY 3 LLC (0016987)

12/31/2019License Renewal Fee Due*:

1926 DEANE BLVDRACINE WI 53403(262) 412-3269 MIRANDA YOUNGCounty: RACINE

A+ JUST LIKE FAMILY LLC

620 SILENT SUNDAYRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 412-3269MIRANDA YOUNG

5,565/8,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

Initial License: 02/20/2012

A+ JUST LIKE FAMILY AFH (0013921)

01/31/2020License Renewal Fee Due*:

2427 RUSSET STRACINE WI 53405(262) 412-1482 TARAL PATELCounty: RACINE

AARNA FAMILY CARE LLC

3839 BLOSSOM DRRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 939-6661TARAL PATEL

3,500/9,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 04/04/2018

AARNA FAMILY CARE LLC (0016897)

03/31/2020License Renewal Fee Due*:

4800 KINZIE AVERACINE WI 53406(262) 583-4619 PRISCELLA WHITECounty: RACINE

ABOVE & BEYOND ADULT FAMILY HOME LLC

5801 WASHINGTON AVE SUITE 205MT PLEASANT WI 53406

Type: Class:

Low/High rate:

AFH(262) 417-2796PRISCELLA WHITE

4,500/10,000 - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/08/2015

ABOVE & BEYOND AFH PHASE I (0015549)

05/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 8

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

5404 WRIGHT AVERACINE WI 53406(262) 456-2250 PRISCELLA WHITECounty: RACINE

ABOVE AND BEYOND ADULT FAMILY HOME LLC

5734 RANDAL LANERACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 417-2796PRISCELLA WHITE

3,600/4,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

Initial License: 04/05/2011

ABOVE AND BEYOND ADULT FAMILY HOME (0013672)

02/28/2019License Renewal Fee Due*:

3600 10TH AVERACINE WI 53403

ALLYSON BOUIECounty: RACINE

ALLYSONSADULT FAMILY HOME LLC

3669 ERIE STRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 672-9735ALLYSON BOUIE

4,711/8,617M/F - 3

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/06/2017

ALLYSONS ADULT HOME II (0016469)

03/31/2019License Renewal Fee Due*:

1683 PERRY AVERACINE WI 53405(262) 633-7484 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

2,850/5,000M - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/01/1989

ALPHA HOMES OF WISCONSIN I (390119)

01/31/2020License Renewal Fee Due*:

4212 DURAND AVERACINE WI 53406(262) 554-8856 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

3,400/3,400M/F - 4

DEVELOPMENTALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/01/1987

ALPHA HOMES OF WISCONSIN II (0008611)

04/30/2020License Renewal Fee Due*:

1727 STODDARD CIRCLERACINE WI 53406(262) 886-5139 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

3,150/3,150M - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 11/01/1988

ALPHA HOMES OF WISCONSIN III (390120)

10/31/2018License Renewal Fee Due*:

1427 OHIO STRACINE WI 53405(262) 633-6845 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

3,420/3,420M - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/01/1987

ALPHA HOMES OF WISCONSIN IV (390121)

10/31/2018License Renewal Fee Due*:

5238 ADMIRALTY DRRACINE WI 53405(262) 554-6035 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

2,850/5,000M/F - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/01/1987

ALPHA HOMES OF WISCONSIN V (0008612)

01/31/2020License Renewal Fee Due*:

701 CARLTON DRRACINE WI 53404(262) 639-5449 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

4,740/4,740M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/01/1998

ALPHA HOMES OF WISCONSIN VI (0008614)

10/31/2018License Renewal Fee Due*:

5405 ERIE STRACINE WI 53402(262) 639-4010 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

4,860/4,860M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/04/1990

ALPHA HOMES OF WISCONSIN VII (390123)

08/31/2018License Renewal Fee Due*:

2126 SUTTON DRRACINE WI 53406(262) 886-1766 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

3,750/3,750M/F - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/30/2006

ALPHA HOMES OF WISCONSIN XVIII (0011654)

10/31/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 9

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

6435 KINZIE AVERACINE WI 53406(262) 886-3328 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVERACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID J DUFFECK

5,910/7,710M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 08/20/2008

ALPHA HOMES OF WISCONSIN XX (0012314)

08/31/2018License Renewal Fee Due*:

1703 W 6TH STRACINE WI 53404(262) 637-7117 AMY HAMILTONCounty: RACINE

AMYS ADULT FAMILY HOME LLC

1701 W 6TH STRACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 637-7117AMY HAMILTON

4,000/15,000M/F - 4

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/16/2005

AMYS ADULT FAMILY HOME (0011232)

11/30/2019License Renewal Fee Due*:

1719 GRAND AVENUERACINE WI 53403(262) 637-7117 AMY HAMILTONCounty: RACINE

AMYS ADULT FAMILY HOME, LLC

1701 WEST 6TH STREETRACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 412-3355AMY HAMILTON

5,000/10,000M/F - 3

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/14/2013

AMYS ADULT FAMILY HOME 3 (0014725)

10/31/2019License Renewal Fee Due*:

2062 GEORGIA AVERACINE WI 53404(262) 412-3355 AMY HAMILTONCounty: RACINE

AMYS ADULT FAMILY HOME LLC

1701 WEST 6TH STRACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 412-3355AMY HAMILTON

5,550/6,200M/F - 3

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/05/2016

AMYS ADULT FAMILY HOME 4 (0016036)

11/30/2018License Renewal Fee Due*:

2001 CENTER STREETRACINE WI 53403(262) 497-4433 GREGORY MOORECounty: RACINE

2001 Center StreetRACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 497-4433GREGORY MOORE

3,000/10,500M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/07/2014

BEST CARE RESIDENTIAL AFH (0015141)

07/30/2018License Renewal Fee Due*:

1331 BLUFF AVENUERACINE WI 53403(262) 456-0035 YOLANDA MORACounty: RACINE

1331 BLUFF AVENUERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 822-5336YOLANDA MORA

5,000/6,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/29/2014

BEST HOME CARE OF WI (0015329)

10/31/2018License Renewal Fee Due*:

2524 DONNA AVERACINE WI 53404(262) 822-5336 YOLANDA NAVACounty: RACINE

BEST HOME CARE OF WI #2 LLC

1331 BLUFF AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 822-5336YOLANDA NAVA

5,000/6,000M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/10/2018

BEST HOME CARE OF WI #2 LLC (0016768)

12/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 10

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

5232 ADMIRALTY DRIVERACINE WI 53406(262) 770-4167 SHANTA MCKINNEYCounty: RACINE

HANDS OF HOPE RESIDENTIAL LLC

2436 WEXFORD ROADRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 994-9456SHANTA MCKINNEY

3,441/5,200M/F - 4

ALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/14/2013

BISCAYNE HOUSE (THE) (0014852)

10/31/2019License Renewal Fee Due*:

5645 REGENCY HILLS DRRACINE WI 53406(262) 672-3936 LEKESHA GRAYSCounty: RACINE

141 MAIN ST APT 122RACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 994-5485LEKESHA GRAYS

2,500/9,000M/F - 4

ALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/29/2011

BLESSED ASSURANCE ADULT FAMILY HOME (0013784)

09/30/2019License Renewal Fee Due*:

5638 BYRD AVERACINE WI 53406(262) 456-2008 DEPHENIA CONLEYCounty: RACINE

DEPHENIA CONLEY

5638 BYRD AVERACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 456-2008DEPHENIA CONLEY

4,562/5,049M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 02/06/2003

BRESHA SERENITY HOUSE (0009950)

02/28/2019License Renewal Fee Due*:

2115 YOUT STRACINE WI 53402

DEPHENIA CONLEYCounty: RACINE

2115 YOUT STRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 880-6856DEPHENIA CONLEY

10,370/12,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 02/16/2017

BRESHA SERENITY HOUSE II (0016381)

02/28/2019License Renewal Fee Due*:

5424 ATHENS AVERACINE WI 53406(262) 619-1529 ANTHONY MCWHORTERCounty: RACINE

ANTHONY MCWHORTER

P O BOX 085718RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 909-0841ANTHONY MCWHORTER

6,000/7,500M - 3

DEVELOPMENTALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 03/16/2004

BRI MC ADULT FAMILY HOME (0010466)

03/31/2020License Renewal Fee Due*:

1928 NEPTUNE AVENUERACINE WI 53404(262) 664-3360 DEANNA RINZCounty: RACINE

BRIGHTER DAY AFH LLC

1102 YOUT STREETRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 497-4951DEANNA RINZ

3,000/12,000M/F - 4

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILL

Gender - Capacity:

Initial License: 04/03/2014

BRIGHTER DAY AFH (0014989)

03/31/2020License Renewal Fee Due*:

3435 ERIE STREETRACINE WI 53402(262) 800-3445 DEANNA RINZCounty: RACINE

BRIGHTER DAY AFH, LLC

1928 NEPTUNE AVENUERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 497-4951DEANNA RINZ

3,000/12,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/15/2014

BRIGHTER DAY AFH TOO (0015406)

12/30/2018License Renewal Fee Due*:

4101 SHADOW LNRACINE WI 53405(262) 497-1550 LAURI ROGERSCounty: RACINE

CAMELLIA HOMES

PO BOX 85893RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 497-1550LAURI ROGERS

4,000/6,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/08/2016

CAMELLIA HOMES-MAGNOLIA HOUSE (0016236)

08/31/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 11

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1435 DOUGLAS AVERACINE WI 53404(262) 412-5937 SUHER MOHAMEDCounty: RACINE

CARIBE ASSISTED LIVING II LLC

1419 SUPERIOR STREETRACINE WI 53402

Type: Class:

Low/High rate:

AFH(414) 745-0216SUHER MOHAMED

8,850/10,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/05/2017

CARIBE ASSISTED LIVING II (0016684)

06/30/2019License Renewal Fee Due*:

1415 SUPERIOR STREETRACINE WI 53402(414) 745-0216 SUHER MOHAMEDCounty: RACINE

CARIBE ASSISTED LIVING, LLC

1419 SUPERIOR STREETRACINE WI 53402

Type: Class:

Low/High rate:

AFH(414) 745-0216SUHER MOHAMED

8,500/10,850M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/22/2014

CARIBE ASSISTED LIVING LLC (0015001)

07/31/2018License Renewal Fee Due*:

2826 Arlington AvenueRacine WI 53403(262) 989-0047 Thomas AlexandraCounty: RACINE

141 Main Street Unit 122Racine WI 53403

Type: Class:

Low/High rate:

AFH(262) 989-0047Alexandra Thomas

3,000/10,000M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/11/2016

Caring Hearts AFH (0015586)

01/31/2020License Renewal Fee Due*:

1509 ROOSEVELT AVERACINE WI 53406(262) 456-1751 SHANTA MCKINNEYCounty: RACINE

2436 WEXFORD RDMOUNT PLEASANT WI 53405

Type: Class:

Low/High rate:

AFH(262) 994-9456SHANTA MCKINNEY

3,552/5,250M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/26/2012

CHARMING HOUSE II (THE) (0014105)

03/31/2020License Renewal Fee Due*:

119 CRAB TREE LANERACINE WI 53406(262) 456-4216 CHARTAYA DIGGINSCounty: RACINE

CHERISH WITH LOVE HOME, LLC

1833 WOODLAND AVENUERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 321-4037CHARTAYA DIGGINS

6,300/7,900M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 07/22/2014

CHERISH WITH LOVE HOME (0015023)

07/31/2018License Renewal Fee Due*:

4208 MARQUETTERACINE WI 53402(262) 930-4238 CHARTAYA DIGGINSCounty: RACINE

1833 WOODLAND AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 930-4238CHARTAYA DIGGINS

18,116/25,200M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License:

CHERISH WITH LOVE HOME LLC 2 (0016248)

10/31/2018License Renewal Fee Due*:

3908 RUBY AVERACINE WI 53402(262) 639-6252 LISA WALKERCounty: RACINE

COMMUNITY PATHWAYS LLC

PO BOX 044211RACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 639-6252LISA WALKER

4,245/4,245M/F - 4

ALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/18/2008

COMMUNITY PATHWAYS LLC RUBY HOUSE II (0012635)

12/31/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 12

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

3744 DOUGLAS AVERACINE WI 53402(262) 639-6242 LISA WALKERCounty: RACINE

COMMUNITY PATHWAYS LLC

PO BOX 044211RACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 639-6252LISA WALKER

5,080/5,080M/F - 4

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPREGNANT WOMEN/COUNSELLINGPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/08/2010

COMMUNITY PATHWAYS LLC VICTORY HOUSE I (0013129)

02/28/2020License Renewal Fee Due*:

3736 DOUGLAS AVERACINE WI 53402(262) 639-0264 LISA WALKERCounty: RACINE

COMMUNITY PATHWAYS LLC

P O BOX 044211RACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 930-0483LISA WALKER

5,500/6,000M/F - 3

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/05/2011

COMMUNITY PATHWAYS LLC VICTORY HOUSE II (0013694)

04/30/2019License Renewal Fee Due*:

3906 RUBY AVERACINE WI 53402(262) 930-0483 LISA WALKERCounty: RACINE

COMMUNITY PATHWAYS LLC

PO BOX 044211RACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 639-6252LISA WALKER

4,245/4,245M/F - 4

ALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/02/2008

COMMUNITY PATHWAYS RUBY HOUSE I (0012402)

05/31/2020License Renewal Fee Due*:

3622 SOUTHWOOD DRIVERACINE WI 53406(262) 822-0174 TRENNIE EPPSCounty: RACINE

2300 ASHLAND AVENUERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 412-7477TRENNIE EPPS

4,000/7,200M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

Initial License: 06/30/2011

COMMUNITY TIES (0013714)

05/31/2019License Renewal Fee Due*:

433 GRAHAM STRACINE WI 53405(262) 634-0712 MARIA D RODRIGUEZCounty: RACINE

COMPASSIONET & CARE LLC

2035 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 634-0712MARIA D RODRIGUEZ

4,845/6,000M/F - 4

DEVELOPMENTALLY DISABLEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/18/2010

COMPASSIONET & CARE 1 (0013232)

04/30/2020License Renewal Fee Due*:

1400 S WISCONSIN AVERACINE WI 53403(262) 456-0880 MARIA RODRIGUEZCounty: RACINE

COMPASSIONET AND CARE LLC

2035 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 880-8938MARIA D RODRIGUEZ

4,845/6,000M/F - 4

DEVELOPMENTALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/31/2011

COMPASSIONET AND CARE LLC II (0013655)

02/28/2019License Renewal Fee Due*:

4125 16TH STRACINE WI 53405(262) 632-1463 ANN HEDRINGTONCounty: RACINE

COUNTRY MEADOWS FAMILY CARE LLC

18012 65TH CTFRANKSVILLE WI 53126

Type: Class:

Low/High rate:

AFH(414) 397-9425ANN HEDRINGTON

15,000/17,065M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/24/2010

COUNTRY MEADOWS FAMILY CARE LLC (0013311)

05/31/2020License Renewal Fee Due*:

1009 DAVIS PLRACINE WI 53403(262) 456-6747 MARY CORNELIOUSCounty: RACINE

CORNELIOUS HOME LLC

1611 W 6 TH STRACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 637-3338MARY CORNELIOUS

3,000/3,500M/F - 4

ADVANCED AGEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

Initial License: 10/14/2009

DAVIS PLACE (0013014)

10/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 13

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1021 DELAMERE AVERACINE WI 53403(262) 902-9790 MELINDA THOMPSONCounty: RACINE

DELAMERES PLACE TO CALL HOME AFGH LLC

3315 N 81ST STMILWAUKEE WI 53222

Type: Class:

Low/High rate:

AFH(262) 902-9790MELINDA THOMPSON

5,700/7,000M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/17/2018

DELAMERES PLACE TO CALL HOME AFGH LLC (0017114)

04/30/2020License Renewal Fee Due*:

2419 JEAN AVERACINE WI 53404(262) 633-3066 MELISSA SOTOCounty: RACINE

DESTINY ADULT FAMILY HOMES LLC

PO BOX 085502RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 633-3066HELEN CLARK MACLIN

3,000/7,500M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/09/2002

DESTINY ADULT FAMILY HOME I (0009607)

04/30/2020License Renewal Fee Due*:

1009 MAYFAIR DRRACINE WI 53402(262) 681-2325 HENDERSON MACLINCounty: RACINE

DESTINY ADULT FAMILY HOMES LLC

PO BOX 085502RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 633-3066HENDERSON MACLIN

3,000/8,000M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/21/2003

DESTINY ADULT FAMILY HOME II (0010067)

04/30/2019License Renewal Fee Due*:

1011 MAYFAIR DRRACINE WI 53402(262) 308-1290 MELISSA SOTOCounty: RACINE

DESTINY ADULT FAMILY HOMES LLC

PO BOX 085502RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 559-6543HENDERSON MACLIN

3,500/8,000M/F - 3

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/03/2007

DESTINY ADULT FAMILY HOME III (0012075)

09/30/2019License Renewal Fee Due*:

2301 ROMAYNE AVE UPPERRACINE WI 53408(262) 619-0656 HENDERSON CLARK MACLINCounty: RACINE

PO BOX 085502RACINE WI 53408

Type: Class:

Low/High rate:

AFH(414) 559-6543HENDERSON MACLIN

4,000/8,000M/F - 3

ALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/04/2015

DESTINY ADULT FAMILY HOMES V (0015604)

05/31/2019License Renewal Fee Due*:

2301 ROMAYNERACINE WI 53404(262) 308-1290 MELISSA SOTOCounty: RACINE

DESTINY ADULT FAMILY HOMES LLC

PO BOX 085502RACINE WI 53408

Type: Class:

Low/High rate:

AFH() -HELEN CLARK MACLIN

3,500/8,000M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/19/2012

DESTINY AFH LLC IV (0013920)

12/31/2019License Renewal Fee Due*:

3038 CHICKORY ROADRACINE WI 53403(262) 770-4386 DAQUET REEDCounty: RACINE

CREEKSIDE FAMILY CARE LLC

3038 CHICKORY ROADRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 770-4386DAQUET REED

3,200/100,000M/F - 3

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 09/11/2017

DONNAS HOUSE (0016758)

08/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 14

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1236 BLUFF AVERACINE WI 53403(262) 504-9450 ESTELLE L BARLOWCounty: RACINE

ENDLESS CARE LLC

PO BOX 85151RACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 504-9450ESTELLE L BARLOW

3,000/10,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPREGNANT WOMEN/COUNSELLINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/02/2017

ENDLESS CARE LLC (0016503)

04/30/2019License Renewal Fee Due*:

2220 SUMMIT AVERACINE WI 53404(262) 456-1972 VONDA BROWNCounty: RACINE

VONDA K BROWN

141 OHIO STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 822-7961VONDA BROWN

4,265/5,130M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/25/2009

EXCEL (0012795)

06/30/2019License Renewal Fee Due*:

139 OHIO STREETRACINE WI 53405(262) 456-6289 VONDECAIR BROWNCounty: RACINE

141 OHIO STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 822-7961VONDECAIR BROWN

3,940/5,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/22/2014

EXCEL FOUR (0015035)

04/30/2020License Renewal Fee Due*:

2019 GREEN ST LOWERRACINE WI 53402(262) 800-1384 JASMINE MALONECounty: RACINE

2019 GREEN ST UPPERRACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 383-1443JASMINE MALONE

5,200/6,800M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/27/2017

EXCEL R3 (0016698)

11/30/2019License Renewal Fee Due*:

2040 CASE AVERACINE WI 53405(262) 583-1327 VONDECAIR BROWNCounty: RACINE

VONDECAIR BROWN

141 OHIO STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 822-7961VONDECAIR BROWN

3,940/5,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/21/2016

EXCEL SIX (0015750)

01/31/2020License Renewal Fee Due*:

4300 MARYLAND AVERACINE WI 53405(262) 456-2451 VONDA BROWNCounty: RACINE

141 OHIO STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 822-7961VONDA BROWN

4,500/5,301M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/30/2011

EXCEL THREE (0013704)

05/31/2019License Renewal Fee Due*:

2051 CHARLES STRACINE WI 53402(262) 260-8825 VONDA BROWNCounty: RACINE

141 OHIO STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 822-7961VONDA BROWN

3,480/4,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/17/2009

EXCEL TWO (0013125)

12/31/2019License Renewal Fee Due*:

5025 MARYLAND AVERACINE WI 53406(262) 456-6535 DYLAND WEATHERCounty: RACINE

FAITH COMMUNITY ADULT GROUP HOME LLC

115 ALGONQUIN STREETBATTLE CREEK MI 49037

Type: Class:

Low/High rate:

AFH(262) 989-0232DONALD W WATSON

4,582/4,950M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/25/2013

FAITH COMMUNITY ADULT GROUP HOME (0014776)

09/30/2019License Renewal Fee Due*:

3317 OAKWOOD DRIVERACINE WI 53406(262) 554-3233 DYLAND WEATHERCounty: RACINE

FAITH COMMUNITY ADULT GROUP HOME LLC

115 ALGONQUIN STREETBATTLE CREEK MI 49037

Type: Class:

Low/High rate:

AFH(262) 989-0232DONALD WATSON

4,500/4,900M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDING

Gender - Capacity:

Initial License: 01/19/2012

FAITH GROUP HOME (0013990)

12/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 15

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

2044 FRANKLIN STREETRACINE WI 53403(262) 721-4602 NORA L JONESCounty: RACINE

FLORAS PLACE

2016 MEAD STREETRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 721-4602NORA L JONES

3,000/10,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESS

Gender - Capacity:

Initial License: 02/06/2017

FLORAS PLACE (0016410)

01/31/2019License Renewal Fee Due*:

1426 CARLISLE AVERACINE WI 53404(262) 637-4709 EUREKA BELLCounty: RACINE

FORGET ME NOT LLC

1426 CARLISLE AVERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 637-4709EUREKA BELL

3,000/10,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/25/2017

FORGET ME NOT (0016613)

05/31/2019License Renewal Fee Due*:

1743 SPRING STREETRACINE WI 53404(262) 770-4084 ROMAN YISSAKCounty: RACINE

GOLDEN AGE CARE, LLC

2310 S GREEN BAY RD STE C #297RACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 770-4084ROMAN YISSAK

4,200/4,650M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/26/2013

GOLDEN AGE CARE (1743) (0014855)

11/30/2019License Renewal Fee Due*:

1745 SPRING STREETRACINE WI 53404(262) 770-4084 ROMAN YISSAKCounty: RACINE

GOLDEN AGE CARE, LLC

2310 S GREEN BAY RD STE C #297RACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 770-4084ROMAN YISSAK

4,200/4,650M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/26/2013

GOLDEN AGE CARE (1745) (0014856)

11/30/2019License Renewal Fee Due*:

1663 Village DriveRacine WI 53406(262) 770-4084 Abraham IsaacCounty: RACINE

Golden Age Care 1661 LLC

2310 S Green Bay Rd Ste C #297Racine WI 53406

Type: Class:

Low/High rate:

AFH(414) 739-1609Abraham Isaac

4,200/4,650M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILL

Gender - Capacity:

Initial License: 08/19/2015

Golden Age Care 1663 (0015594)

08/31/2019License Renewal Fee Due*:

3023 GILSON STREETRACINE WI 53403(702) 301-2364 JOREENA COBBCounty: RACINE

HEALING HANDZ HOMECARE LLC

3023 GILSON STREETRACINE WI 53403

Type: Class:

Low/High rate:

AFH(702) 301-2364JOREENA COBB

5,000/5,500M/F - 3

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/16/2017

HEALING HANDZ (0016644)

06/30/2019License Renewal Fee Due*:

3711 LATHROP AVERACINE WI 53405(262) 554-6239 RACHEL JOHNSONCounty: RACINE

HERITAGE HOMES LIVING, LLC

1209 NEWMAN ROADRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 939-5000RACHEL JOHNSON

5,448/8,548M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/28/2014

HERITAGE HOMES LIVING LLC (0015046)

05/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 16

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

4119 LASALLE STREETRACINE WI 53402(262) 554-4715 PATSY MUNOZCounty: RACINE

PATSY J MUNOZ

3127 DEBRA LNRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 554-4715PATSY MUNOZ

6,000/12,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 01/30/2017

HOME OF HFL LLC (0016341)

01/31/2019License Renewal Fee Due*:

3339 MONARCH DRIVERACINE WI 53403(262) 939-3666 AMIT PATELCounty: RACINE

HOMEWOOD ADULT FAMILY HOME LLC

2054 KEARNEY AVENUERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 939-3666AMIT PATEL

6,500/8,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/08/2015

HOMEWOOD ADULT FAMILY HOME LLC (0015517)

03/31/2019License Renewal Fee Due*:

3100 BARBARA DRRACINE WI 53402(262) 554-7057 REGINIA JOHNSONCounty: RACINE

SHERRIAN BOYD

1939 JAY EYE SEE AVRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 632-1082SHERRIAN BOYD

12,540/16,642M - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESS

Gender - Capacity:

Initial License: 09/23/2013

HOPE AWAY FROM HOME (0014727)

09/30/2019License Renewal Fee Due*:

2826 ORCHARD STRACINE WI 53405(262) 488-0850 BOBBIE HICKSCounty: RACINE

HICKS INC

2328 VIRGINIA STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 488-0850BOBBIE HICKS

3,000/7,500M/F - 3

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/20/2017

HOUSE OF FAITH HOPE LOVE 2 (0016501)

09/30/2019License Renewal Fee Due*:

1518 HARMONY DRRACINE WI 53402

THERESA LOVE TOMLINCounty: RACINE

1318 CENTER STREETRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 989-1629THERESA LOVE TOMLIN

4,000/4,750M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/20/2016

HOUSE OF LOVE LLC ADULT FAMILY HOME (0016121)

06/30/2020License Renewal Fee Due*:

2201 HOWE STRACINE WI 53403(262) 752-3830 CHANEL NELSONCounty: RACINE

NATURALLY NURTURED LLC

1430 VILLA STRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 752-3830CHANEL NELSON

3,500/10,500M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License:

HOWE WE NATURALLY NURTURE (0016458)

09/30/2019License Renewal Fee Due*:

6 MCKINLEY AVENUERACINE WI 53404(262) 880-6019 SHAKITA BOBOCounty: RACINE

HUNTING FOR MORE LOVE LLC

6005 JOANNE DR APT 202MT PLEASANT WI 53406

Type: Class:

Low/High rate:

AFH(262) 880-6019SHAKITA BOBO

3,500/5,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/09/2017

HUNTING FOR MORE LOVE (0016649)

07/31/2019License Renewal Fee Due*:

1329 KEWAUNEE STREETRACINE WI 53404(262) 930-3339 TATREANA MAYFIELDCounty: RACINE

1329 KEWAUNEE STREETRACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 412-6226TATREANA MAYFIELD

4,190/4,340M/F - 4

ALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPREGNANT WOMEN/COUNSELLING

Gender - Capacity:

Initial License: 01/21/2016

INDEPENDENT MOVEMENT (0015466)

01/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 17

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1429 OREGON STREETRACINE WI 53405(262) 681-2530 SHANTA MCKINNEYCounty: RACINE

HANDS OF HOPE RESIDENTIAL LLC

2436 WEXFORD ROADRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 994-9756SHANTA MCKINNEY

4,000/4,500M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/06/2017

IVYS PLACE (0016617)

05/31/2019License Renewal Fee Due*:

2519 LORAINE AVERACINE WI 53404(262) 637-7097 LAVONDA PERKINSCounty: RACINE

K&D ADULT FAMILY HOME LLC

35189 VIA LAGUNAWINCHESTER CA 92596

Type: Class:

Low/High rate:

AFH(760) 500-5908MARK A GILL

160/190M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/01/2009

K&D ADULT FAMILY HOME LLC (0012674)

06/30/2019License Renewal Fee Due*:

3707 10TH AVERACINE WI 53402(262) 637-7097 LAVONDA PERKINSCounty: RACINE

K&D ADULT FAMILY HOME LLC

35189 VIA LAGUNAWINCHESTER CA 92596

Type: Class:

Low/High rate:

AFH(760) 500-5908MARK A GILL

3,000/4,000M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/23/2010

K&D ADULT FAMILY HOMES LLC II (0013176)

02/28/2020License Renewal Fee Due*:

3709 10TH AVERACINE WI 53402(262) 930-2925 LAVONDA PERKINSCounty: RACINE

K&D ADULT FAMILY HOME LLC

35189 VIA LAGUNAWINCHESTER CA 92596

Type: Class:

Low/High rate:

AFH(760) 500-5908MARK A GILL

2,500/3,500M/F - 3

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/13/2011

K&D AFH LLC #3 (0013710)

06/30/2019License Renewal Fee Due*:

2627 JEAN AVERACINE WI 53404(262) 994-8319 LAVONDA PERKINSCounty: RACINE

K&D ADULT FAMILY HOME LLC

2818 DONNA AVERACINE WI 53404

Type: Class:

Low/High rate:

AFH(760) 500-5908LAVONDA PERKINS

3,000/4,000M/F - 3

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/18/2017

K&D AFH LLC 4 (0016513)

05/31/2019License Renewal Fee Due*:

2903 KENWOOD DRRACINE WI 53403(262) 456-4229 HOPE SOUTERCounty: RACINE

KENWOOD KEYS INC

PO BOX 085465RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 456-1801HOPE SOUTER

4,500/11,873M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 04/28/2015

KENWOOD KEYS INCORPORATED KENWOOD 2 (0015571)

04/30/2019License Renewal Fee Due*:

1901 SATURN AVERACINE WI 53404(262) 488-1131 DANIEL RODRIGUEZCounty: RACINE

KIND CARE LLC

1901 SATURN AVERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 488-1131DANIEL RODRIGUEZ

4,200/6,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/13/2017

KIND CARE LLC (0016364)

06/30/2019License Renewal Fee Due*:

4618 KINZIE AVERACINE WI 53405(262) 456-2388 HOPE SOUTERCounty: RACINE

KENWOOD KEYS INC

PO BOX 085465RACINE WI 53406-5465

Type: Class:

Low/High rate:

AFH(262) 456-2388HOPE SOUTER

4,397/5,205M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 04/27/2009

KINZIE PLACE (0012747)

04/30/2019License Renewal Fee Due*:

3900 KNOLL PLACERACINE WI 53403(262) 456-1801 HOPE SOUTERCounty: RACINE

KINZIE WAY LLC

PO BOX 085465RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 498-6640HOPE SOUTER

5,000/9,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 05/22/2018

KINZIE WAY LLC (0017042)

05/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 18

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

3800 KNOLL PLRACINE WI 53403(262) 456-0574 HOPE SOUTERCounty: RACINE

KENWOOD KEYS INC

PO BOX 085465RACINE WI 53408-5465

Type: Class:

Low/High rate:

AFH(262) 456-6640HOPE SOUTER

4,500/11,873M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 05/03/2007

KNOLL PLACE (0011487)

04/30/2019License Renewal Fee Due*:

1824 HOLMES AVERACINE WI 53403(262) 327-1962 NAKHAKA DAVISCounty: RACINE

LIBERTY WILLOWS ADULT FAMILY HOME LLC

1703 HOLMES AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 327-1962NAKHAKA DAVIS

5,800/6,900M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/17/2017

LIBERTY WILLOWS ADULT FAMILY HOME LLC (0016800)

10/31/2019License Renewal Fee Due*:

3620 SOVEREIGN DRRACINE WI 53406(262) 412-7054 JACQUELINE MCRAECounty: RACINE

LIFESTYLE ADULT CARE HOMES LLC

P O BOX 085943RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 412-7054JACQUELINE MCRAE

4,000/6,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/08/2010

LIFESTYLE ADULT FAMILY HOME 1 (0010694)

01/31/2020License Renewal Fee Due*:

3628 SOVEREIGN DRRACINE WI 53406(262) 412-7054 JACQUELINE MCRAECounty: RACINE

LIFESTYLE ADULT CARE HOMES LLC

P O BOX 085943RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 412-7054JACQUELINE MCRAE

4,000/6,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/04/2011

LIFESTYLE ADULT FAMILY HOME 2 (0013686)

03/31/2019License Renewal Fee Due*:

3614 SOVEREIGN DRRACINE WI 53406(262) 412-7054 JACQUELINE MCRAECounty: RACINE

LIFESTYLE ADULT CARE HOMES LLC

P O BOX 085943RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 412-7054JACQUELINE MCRAE

4,000/6,500M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/23/2011

LIFESTYLE ADULT FAMILY HOME 3 (0013861)

10/31/2019License Renewal Fee Due*:

3616 SOVEREIGN DRIVERACINE WI 53406(262) 554-6614 JACQUELINE MCRAECounty: RACINE

LIFESTYLE ADULT CARE HOMES, LLC

PO BOX 085943RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 412-7054JACQUELINE MCRAE

4,000/6,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 07/11/2013

LIFESTYLE ADULT FAMILY HOME 4 (0014696)

06/30/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 19

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

5224 ADMIRALTY DRIVERACINE WI 53406(262) 554-1934 JACQUELINE MCRAECounty: RACINE

LIFESTYLE ADULT CARE HOMES, LLC

PO BOX 085943RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 412-7054JACQUELINE MCRAE

4,000/8,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/10/2014

LIFESTYLE ADULT FAMILY HOME 5 (0014939)

02/28/2020License Renewal Fee Due*:

1001 CENTER STRACINE WI 53403(414) 610-5984 NOOR TWAMCounty: RACINE

LOVE N COMFORT LLC

1001 CENTER STRACINE WI 53403

Type: Class:

Low/High rate:

AFH(414) 610-5984NOOR TWAM

8,000/9,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/28/2017

LOVE N COMFORT GROUP HOME (0016423)

02/28/2019License Renewal Fee Due*:

1638 ECHO LNRACINE WI 53403(262) 412-5219 NICOLE COBBCounty: RACINE

LOVE OF CARING LLC

922 WISCONSIN AVERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 412-5219NICOLE COBB

3,500/4,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURYWAIVER CERTIFIED INDEPENDENT CBRF APTS

Gender - Capacity:

Initial License: 10/16/2012

LOVE OF CARING LLC (0014227)

09/30/2018License Renewal Fee Due*:

101 HOWLAND AVERACINE WI 53403(262) 412-5219 NICOLE COBBCounty: RACINE

LOVE OF CARING LLC

1638 ECHO LANERACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 412-5219NICOLE COBB

3,500/4,500M - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/14/2011

LOVE OF CARING LLC (0013582)

10/31/2019License Renewal Fee Due*:

2214 WILLIAM STREETRACINE WI 53406(262) 412-5219 NICOLE COBBCounty: RACINE

LOVE OF CARING LLC

1638 ECHO LANERACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 412-5219NICOLE COBB

4,550/6,000M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/06/2016

LOVE OF CARING LLC DAISY AFH (0016012)

11/30/2018License Renewal Fee Due*:

1834 13TH STREETRACINE WI 53403(262) 412-5219 NICOLE COBBCounty: RACINE

LOVE OF CARING LLC

1638 ECHO LANERACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 412-5219NICLOE COBB

4,835/6,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/06/2016

LOVE OF CARING LLC TULIP AFH (0016015)

11/30/2018License Renewal Fee Due*:

703 HAYES AVERACINE WI 53405(262) 721-6907 JAMIE YOUNGCounty: RACINE

P O BOX 81232RACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 721-6907JAMIE YOUNG

3,000/10,000M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

Initial License: 09/17/2015

LOVING MEADOWS AFH (0015762)

09/30/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 20

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

4140 MANHATTAN DRIVERACINE WI 53402(262) 902-9790 MELINDA THOMPSONCounty: RACINE

MANHATTAN HOME ADULT FAMILY GROUP HOM

310 5TH STREET SUITE 101BRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 902-9790MELINDA THOMPSON

4,000/5,700M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 12/08/2015

MANHATTAN HOME ADULT FAMILY GROUP HOME (001545

11/30/2019License Renewal Fee Due*:

2400 KINZIE AVERACINE WI 53405(262) 637-8362 BEATRICE JOHNSONCounty: RACINE

MANNA HOUSE ADULT FAMILY HOME LLC (THE)

2400 KINZIE AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 902-3338BEATRICE JOHNSON

4,250/6,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/17/2009

MANNA HOUSE (THE) (0012956)

12/31/2019License Renewal Fee Due*:

5140 KINGS CIRCLERACINE WI 53406(262) 456-1087 LUIS GONZALEZCounty: RACINE

5140 KINGS CIRCLERACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 945-4249LUIS GONZALEZ

10,000/11,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 10/30/2014

MARINAS GROUP HOME (0015330)

10/31/2018License Renewal Fee Due*:

920 OHIO STREETRACINE WI 53405(262) 632-1993 GERALD L HOUSE LISA WALKER-HOUSECounty: RACINE

GERALD L HOUSE & LISA WALKER-HOUSE

3425 KENTUCKY STREETRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 632-1993LISA WALKER-HOUSE

2,500/3,500M - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 02/07/2013

MARSHAS ADULT FAMILY HOME LLC (0014517)

01/31/2019License Renewal Fee Due*:

2023 GILLEN STREETRACINE WI 53403(262) 939-6661 TARAL PATELCounty: RACINE

MIL FAMILY CARE LLC

3839 BLOSSOM DRIVERACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 939-6661TARAL PATEL

2,800/9,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 01/15/2016

MIL FAMILY CARE LLC (0015580)

01/31/2020License Renewal Fee Due*:

1644 DEANE BLVDRACINE WI 53405(262) 977-0717 CIARA READYCounty: RACINE

1644 DEANE BLVDRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 977-0717CIARA READY

5,000/10,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESS

Gender - Capacity:

Initial License: 08/01/2016

MORNING GLORY ADULT FAMILY HOME (0016150)

07/31/2018License Renewal Fee Due*:

2301 WILLIAM STRACINE WI 53404(262) 822-4603 CHAUNTEL VINSONCounty: RACINE

MOUNT PLEASANT HOMES LLP

PO BOX 44132RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 412-9299CHAUNTEL VINSON

4,000/7,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/25/2018

MOUNT PLEASANT HOMES (0017090)

04/30/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 21

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1917 MOUNT PLEASANT STRACINE WI 53404-2628(262) 822-4603 CHAUNTEL VINSONCounty: RACINE

MOUNT PLEASANT HOMES LLP

PO BOX 44132RACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 412-9299CHAUNTEL VINSON

4,000/M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/23/2017

MOUNT PLEASANT HOMES LLP (0016430)

02/28/2019License Renewal Fee Due*:

4307 WRIGHT AVERACINE WI 53405(262) 752-3830 CHANEL NELSONCounty: RACINE

NATURALLY NURTURED

1430 VILLA STRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 752-3830CHANEL NELSON

4,000/10,500M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/20/2016

NATURALLY NURTURED (0016278)

10/31/2018License Renewal Fee Due*:

7931 DANIEL CTRACINE WI 53406(262) 554-0142 SHALANDA BEDFORDCounty: RACINE

NEW VISION ADULT FAMILY HOME LLC

PO BOX 085782RACINE WI 53408-5782

Type: Class:

Low/High rate:

AFH(262) 554-9566SHALANDA BEDFORD

3,000/4,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/11/2007

NEW VISION ADULT FAMILY HOME LLC (0011964)

04/30/2019License Renewal Fee Due*:

3706 OAKWOOD DRIVERACINE WI 53406(262) 822-9862 JESSICA APPLEWHITECounty: RACINE

1333 INDIANA STREETRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 822-9862JESSICA APPLEWHITE

1,500/3,500M/F - 4

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/19/2016

NEW WAY OF LIVING ADULT FAMILY HOME (0016138)

12/31/2018License Renewal Fee Due*:

1223 OHIO STRACINE WI 53405(262) 456-1246 CYLINTIA KNIBBSCounty: RACINE

1223 OHIO STRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 456-1246CYLINTIA KNIBBS

2,500/4,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/01/2004

OHIO ST FAMILY HOME (0010007)

02/28/2020License Renewal Fee Due*:

4845 NATURE TRAILRACINE WI 53403(262) 554-6165 CONNIE OLIVERCounty: RACINE

4845 NATURE TRAILRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 554-6165CONNIE OLIVER

3,000/9,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/21/2008

OLIVER ADULT FAMILY HOME (0012467)

08/31/2018License Renewal Fee Due*:

1621 VIRGINIA STRACINE WI 53403(262) 456-4259 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

5,999M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/15/2016

OPEN ARMS 20 LLC (0016257)

08/31/2018License Renewal Fee Due*:

3519 GREAT ELMS LNRACINE WI 53405(262) 456-2459 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

5,999M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 11/10/2016

OPEN ARMS 20 LLC GREAT ELMS (0016387)

10/31/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 22

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

3200 TAYLOR AVERACINE WI 53405(262) 456-2459 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

5,999M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 11/09/2016

OPEN ARMS 20 LLC TAYLOR (0016388)

10/31/2018License Renewal Fee Due*:

2114 ORCHARD STRACINE WI 53405(262) 880-1873 COURTNEY CONNERCounty: RACINE

ORCHARD ADULT FAMILY HOME LLC

PO BOX 44375RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-1873COURTNEY CONNER

6,000/M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/02/2017

ORCHARD ADULT FAMILY HOME LLC (0016415)

02/28/2019License Renewal Fee Due*:

3410 STRATFORD AVERACINE WI 53402(262) 639-6940 ANGELA ANDERSENCounty: RACINE

COMMUNITY CONNECTION LLC

5225 N IRONWOOD LA STE 116GLENDALE WI 53217

Type: Class:

Low/High rate:

AFH(414) 906-1915ROBERT LIEBERMAN

5,735/5,735M/F - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 01/03/2001

PARADISE HOUSE (0009180)

01/31/2019License Renewal Fee Due*:

129 SHEFFIELD DRRACINE WI 53402(262) 639-5832 ANGELA ANDERSENCounty: RACINE

COMMUNITY CONNECTION LLC

5225 N IRONWOOD LA STE 116GLENDALE WI 53217

Type: Class:

Low/High rate:

AFH(414) 906-1915ROBERT LIEBERMAN

4,560/4,560M - 4

DEVELOPMENTALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 05/31/1996

PHOENIX HOUSE (390092)

05/31/2020License Renewal Fee Due*:

1663 RUSSET STREETRACINE WI 53405(262) 598-4562 LUCY BURGESSCounty: RACINE

PRICELESS TIME ADULT FAMILY HOME LLC

P O BOX 85157RACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 598-4562LUCY BURGESS

5,000/15,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 08/15/2017

PRICELESS TIME ADULT FAMILY HOME IV (0016756)

08/31/2019License Renewal Fee Due*:

1819 BLAKE AVENUERACINE WI 53404(262) 994-3821 LUCY BURGESSCounty: RACINE

PRICELESS TIME ADULT FAMILY HOME LLC

1821 BLAKE AVENUERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 598-4562LUCY BURGESS

4,000/15,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/08/2014

PRICELESS TIME ADULT FAMILY HOME LLC (0015024)

04/30/2020License Renewal Fee Due*:

2807 DONNA AVERACINE WI 53404(262) 880-6019 SHAKITA BOBOCounty: RACINE

HUNTING FOR MORE LOVE LLC

6005 JOANNE DR APT 202MT PLEASANT WI 53406

Type: Class:

Low/High rate:

AFH(262) 880-6019SHAKITA BOBO

3,500/5,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 01/05/2018

PRIDE AND JOY ADULT FAMILY GROUP HOME LLC (001687

12/31/2019License Renewal Fee Due*:

1508 RUSSET STRACINE WI 53405(262) 456-7447 KIMBERLY JOHNSONCounty: RACINE

QUALITY CARE ADULT FAMILY HOME LLC

1916 SATURN AVERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 721-8933KIMBERLY JOHNSON

7,000/9,500M/F - 3

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/30/2016

QUALITY CARE ADULT FAMILY HOME II (0016090)

06/30/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 23

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

1916 SATURN AVERACINE WI 53404(262) 583-4593 KIMBERLY JOHNSONCounty: RACINE

QUALITY CARE ADULT FAMILY HOME LLC

1916 SATURN AVERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 721-8933KIMBERLY JOHNSON

6,000/9,500M/F - 3

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/19/2015

QUALITY CARE ADULT FAMILY HOME LLC (0015833)

10/31/2019License Renewal Fee Due*:

1209 NEWMAN RDRACINE WI 53406(262) 939-5000 RACHEL JOHNSONCounty: RACINE

1209 NEWMAN RDRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 939-5000RACHEL JOHNSON

3,049/5,064M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/13/2011

R JOHNSON HERITAGE HOMES (0013736)

04/30/2019License Renewal Fee Due*:

1936 FRANKLINRACINE WI 53403(262) 822-4303 ANTWAIN MCINTOSHCounty: RACINE

ROOTS RESIDENTIAL ADULT FAMILY HOME LLC

PO BOX 44035RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-5606ANTWAIN MCINTOSH

4,000/7,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/01/2017

ROOTS RESIDENTIAL ADULT FAMILY HOME LLC (0016564)

04/30/2019License Renewal Fee Due*:

1901 FAIRVIEW TERRACERACINE WI 53402(262) 583-4743 ANTWAIN MCINTOSHCounty: RACINE

ROOTS RESIDENTIAL ADULT FAMILY HOME LLC

PO BOX 44035RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-5606ANTWAIN MCINTOSH

4,000/7,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/01/2017

ROOTS RESIDENTIAL ADULT FAMILY HOME LLC (0016563)

04/30/2019License Renewal Fee Due*:

1715 LASALLE STREET UPPERRACINE WI 53402(262) 456-4144 ANTWAIN MCINTOSHCounty: RACINE

ROOTS RESIDENTIAL ADULT FAMILY HOMES LL

PO BOX 44035RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-5606ANTWAIN MCINTOSH

4,000/7,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 08/04/2016

ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC (0016034

07/31/2018License Renewal Fee Due*:

1715 LASALLE STREET LOWERRACINE WI 53402(262) 456-4144 ANTWAIN MCINTOSHCounty: RACINE

ROOTS RESIDENTIAL ADULT FAMILY HOMES LL

PO BOX 44035RACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 880-5606ANTWAIN MCINTOSH

4,000/7,000M/F - 3

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESS

Gender - Capacity:

Initial License: 04/11/2016

ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC (0016022

03/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 24

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

3219 BARBARA DRIVERACINE WI 53404(262) 770-4909 LANA SCHLAGELCounty: RACINE

SAFE HARBOUR HOMES, LLC

8517 IVANHOE PLACERACINE WI 53177

Type: Class:

Low/High rate:

AFH(262) 930-6497WALTER DAVIS

3,875/5,425M/F - 4

ADVANCED AGEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 12/04/2013

SAFE HARBOUR HOMES II LLC (0014832)

11/30/2019License Renewal Fee Due*:

1103 JACKSON PLACERACINE WI 53406(262) 930-6497 LANA SCHLAGELCounty: RACINE

SAFE HARBOUR HOMES LLC

8517 IVANHOE PLACERACINE WI 53177

Type: Class:

Low/High rate:

AFH(262) 822-0723DAVIS WALTER

3,875/5,500 - 4

ADVANCED AGEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 11/16/2015

SAFE HARBOUR HOMES III (0015821)

11/30/2019License Renewal Fee Due*:

1105 JACKSON PLACERACINE WI 53406(262) 930-6497 LANA SCHLAGELCounty: RACINE

SAFE HARBOUR HOMES LLC

8517 IVANHOE PLACERACINE WI 53177

Type: Class:

Low/High rate:

AFH(262) 822-0723DAVIS WALTER

3,875/5,500M/F - 4

ADVANCED AGEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 11/16/2015

SAFE HARBOUR HOMES IV (0015822)

11/30/2019License Renewal Fee Due*:

5224 16TH STREETRACINE WI 53403(262) 770-4909 LANA SCHLAGELCounty: RACINE

SAFE HARBOUR HOMES, LLC

8517 IVANHOE PLACESTURTEVANT WI 53177

Type: Class:

Low/High rate:

AFH(262) 930-6497WALTER DAVIS

3,875/5,425M/F - 4

ADVANCED AGEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 12/05/2013

SAFE HARBOUR HOMES LLC (0014831)

11/30/2019License Renewal Fee Due*:

825 SANDRA CTRACINE WI 53403(262) 939-5621 TWILA COBBCounty: RACINE

HEART FOR CARING HOME CARE LLC

825 SANDRA CTRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 939-5621TWILA COBB

3,500/5,500M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 08/27/2012

SANDRA HOME (0014210)

07/31/2018License Renewal Fee Due*:

3700 OSBORNE BLVDRACINE WI 53405(404) 414-0237 CHERYL WALKERCounty: RACINE

3700 OSBORNE BLVDRACINE WI 53405

Type: Class:

Low/High rate:

AFH(404) 414-0237CHERYL WALKER

2,500/6,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'S

Gender - Capacity:

Initial License: 05/18/2015

SERENITY ON OSBORNE (0015573)

05/31/2019License Renewal Fee Due*:

513 RANDOLPH STREETRACINE WI 53404(773) 368-6428 RICKY COLEMANCounty: RACINE

SHARING IS CARING LLC

513 RANDOLPH STREETRACINE WI 53404

Type: Class:

Low/High rate:

AFH(773) 368-6428RICKY COLEMAN

4,095/4,095M - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/30/2014

SHARING IS CARING (0014723)

04/30/2020License Renewal Fee Due*:

3507 16TH STREETRACINE WI 53405(262) 748-6445 DARIUS YOUNGCounty: RACINE

ST REGIS MANOR AFH LLC

4316 16TH STREETRACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 748-6445DARIUS YOUNG

7,440/10,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/23/2017

ST REGIS MANOR AFH (0016816)

10/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 25

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

826 PARK AVENUERACINE WI 53403(262) 456-7580 EDNA J YOUNGCounty: RACINE

TIME TO TREASURE AFH LLC

PO BOX 597OAK CREEK WI 53154

Type: Class:

Low/High rate:

AFH(262) 880-7036EDNA J YOUNG

3,000/10,000M/F - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/07/2014

THE TREASURE HOUSE (0014997)

03/31/2020License Renewal Fee Due*:

2209 PROSPECT STREETRACINE WI 53406(262) 634-3266 EDNA J YOUNGCounty: RACINE

TIME TO TREASURE AFH S CORPORATION

P O BOX 597OAK CREEK WI 53154

Type: Class:

Low/High rate:

AFH(262) 880-7036EDNA J YOUNG

5,000/10,000M - 4

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/19/2013

TIME TO TREASURE AFH 3 S CORPORATION (0014526)

02/28/2019License Renewal Fee Due*:

842 PARK AVENUERACINE WI 53403(262) 636-0082 EDNA J YOUNGCounty: RACINE

TIME TO TREASURE AFH S CORPORATION

P O BOX 597OAK CREEK WI 53154

Type: Class:

Low/High rate:

AFH(262) 880-7036EDNA J YOUNG

5,000/10,000M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/19/2013

TIME TO TREASURE AFH 4 S CORPORATION (0014527)

02/28/2019License Renewal Fee Due*:

5230 BISCAYNE AVERACINE WI 53406(262) 554-7425 EDNA J YOUNGCounty: RACINE

TIME TO TREASURE AFH S CORPORATION

P O BOX 597OAK CREEK WI 53154

Type: Class:

Low/High rate:

AFH(262) 880-7036EDNA J YOUNG

5,000/10,000F - 3

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/19/2013

TIME TO TREASURE AFH 5 S CORPORATION (0014528)

02/28/2019License Renewal Fee Due*:

5232 BISCAYNE AVERACINE WI 53406(262) 800-3406 EDNA J YOUNGCounty: RACINE

TIME TO TREASURE AFH S CORPORATION

P O BOX 597OAK CREEK WI 53154

Type: Class:

Low/High rate:

AFH(262) 880-7036EDNA J YOUNG

5,000/10,000M - 3

ADVANCED AGEDCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/19/2013

TIME TO TREASURE AFH 6 S CORPORATION (0014529)

02/28/2019License Renewal Fee Due*:

4381 S PINE RIDGE CRRACINE WI 53403(262) 598-0213 JILL TORGERSONCounty: RACINE

JILL TORGERSON

4381 S PINE RIDGE CRRACINE WI 53403

Type: Class:

Low/High rate:

AFH(262) 598-0231JILL TORGERSON

5,061/5,521M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/28/2011

TORGERSON ADULT FAMILY HOME (0013658)

02/28/2019License Renewal Fee Due*:

925 CRAB TREE LANERACINE WI 53406(262) 637-4388 DYLAND WEATHERCounty: RACINE

FAITH COMMUNITY ADULT GROUP HOME LLC

115 ALGONQUIN STBATTLE CREEK MI 49037

Type: Class:

Low/High rate:

AFH(262) 989-0232DONALD WATSON

4,582/5,631M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/18/2013

TRINITY ADULT FAMILY HOME (0014556)

04/30/2019License Renewal Fee Due*:

5532 BYRD AVERACINE WI 53406(262) 634-7320 MARIA RODRIGUEZCounty: RACINE

TRUE LIFE HOMES LLC

2035 LATHROP AVERACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 456-0880MARIA RODRIGUEZ

2,500/4,000M - 4

DEVELOPMENTALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/21/2004

TRUE LIFE HOMES I (0010761)

12/30/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 26

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

920 SOUTH STRACINE WI 53402(262) 456-4191 MARIA RODRIGUEZCounty: RACINE

TRUE LIFE HOMES LLC

2035 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 456-0880MARIA RODRIGUEZ

6,000/24,000M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/18/2006

TRUE LIFE HOMES II (0011524)

10/31/2018License Renewal Fee Due*:

2620 JEAN AVERACINE WI 53404(262) 456-2173 DANIEL/MARIA RODRIGUEZCounty: RACINE

TRUE LIFE HOMES LLC

2035 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 456-0880DANIEL RODRIGUEZ

3,000/8,000M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 06/12/2008

TRUE LIFE HOMES III (0012374)

06/30/2020License Renewal Fee Due*:

621 THUNDERBIRD DRRACINE WI 53402(262) 456-0880 DAN/MARIA RODRIGUEZCounty: RACINE

TRUE LIFE HOMES LLC

2035 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 456-2173DAN/MARIA RODRIGUEZ

5,000/6,100M/F - 4

DEVELOPMENTALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/25/2008

TRUE LIFE HOMES LLC (0012442)

09/30/2018License Renewal Fee Due*:

2428 JEAN AVERACINE WI 53404(262) 456-0880 MARIA D RODRIGUEZCounty: RACINE

TRUE LIFE HOMES LLC

2035 LATHROP AVERACINE WI 53405

Type: Class:

Low/High rate:

AFH(262) 456-0880MARIA D RODRIGUEZ

6,000/24,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'STRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/06/2010

TRUE LIFE HOMES LLC V (0013227)

04/30/2020License Renewal Fee Due*:

7925 DANIEL CTRACINE WI 53406(262) 898-1201 SHALANDA BEDFORDCounty: RACINE

VISIONS OF LIFE LLC

PO BOX 085782RACINE WI 53408-5782

Type: Class:

Low/High rate:

AFH(262) 898-1201SHALANDA BEDFORD

2,500/5,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 09/06/2007

VISIONS OF LIFE LLC (0012076)

08/31/2019License Renewal Fee Due*:

3857 LAKEVIEW DRRACINE WI 53403(262) 898-1216 MARNICKA MCMILLIAMCounty: RACINE

VISIONS OF LIFE LLC

P O BOX 085782RACINE WI 53408-5782

Type: Class:

Low/High rate:

AFH(262) 898-1216SHALANDA BEDFORD

3,000/5,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/27/2010

VISIONS OF LIFE LLC II (0013258)

04/30/2020License Renewal Fee Due*:

3509 S GREEN BAY ROADRACINE WI 53406(262) 554-9566 SHALANDA BEDFORDCounty: RACINE

VISIONS OF LIFE, LLC

PO BOX 085782RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 554-9566SHALANDA BEDFORD

3,000/6,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/10/2013

VISIONS OF LIFE LLC III (0014876)

11/30/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 27

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

6545 LINCOLNSHIRE DRRACINE WI 53403(262) 552-2955 SHALANDA BEDFORDCounty: RACINE

VISIONS OF LIFE LLC

PO BOX 085782RACINE WI 53408

Type: Class:

Low/High rate:

AFH(262) 554-9566SHALANDA BEDFORD

3,000/6,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTCORRECTIONAL CLIENTSDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/03/2013

VISIONS OF LIFE LLC IV (0014770)

09/30/2019License Renewal Fee Due*:

2820 INDIANA STREETRACINE WI 53405(262) 721-6683 LORRAINE WILLIAMSCounty: RACINE

VISTA VILLAGE LIVING CENTER LLC

3806 LAKEVIEW DRIVEMT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(262) 210-6960LORRAINE WILLIAMS

3,500/15,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/17/2017

VISTA VILLAGE LIVING CENTER II (0016602)

04/30/2019License Renewal Fee Due*:

1711 MONROE AVERACINE WI 53405(262) 210-6960 LORRAINE WILLIAMSCounty: RACINE

VISTA VILLAGE LIVING CENTER LLC

3806 LAKEVIEW DRMT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(262) 210-6960LORRAINE WILLIAMS

3,500/15,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/22/2016

VISTA VILLAGE LIVING CENTER III LLC (0015959)

03/31/2020License Renewal Fee Due*:

2705 HAYESRACINE WI 53405(262) 456-0764 LORRAINE WILLIAMSCounty: RACINE

VISTA VILLAGE LIVING CENTER LLC

3806 LAKEVIEW DRIVEMT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(262) 210-6960LORRAINE WILLIAMS

3,500/15,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 04/17/2017

VISTA VILLAGE LIVING CENTER IV (0016603)

04/30/2019License Renewal Fee Due*:

2040 FRANKLIN STRACINE WI 53403(262) 210-6960 LORRAINE WILLIAMSCounty: RACINE

VISTA VILLAGE LIVING CENTER LLC

3806 LAKEVIEW DRMT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(262) 210-6960LORRAINE WILLIAMS

3,500/15,000M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 10/15/2012

VISTA VILLAGE LIVING CENTER LLC (0014302)

09/30/2018License Renewal Fee Due*:

601 SYDNEY DRIVERACINE WI 53402(262) 456-7873 PERE A. EPPSCounty: RACINE

WILLIAMS COMPASSIONATE CARE MANOR, LLC

601 SYDNEY DRIVERACINE WI 53402

Type: Class:

Low/High rate:

AFH(262) 456-7873ROBERT G. WILLIAMS

4,500/8,000M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPUBLIC FUNDINGTERMINALLY ILL

Gender - Capacity:

Initial License: 09/04/2014

WILLIAMS COMPASSIONATE CARE MANOR LLC (0014871)

08/31/2018License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 28

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

3400 SPRUCE STRACINE WI 53405(262) 391-2706 SURENDRAN SIVANANTHANCounty: RACINE

WISCONSIN LIVING LLC (THE)

1630 STARBRIDGE DRBROOKFIELD WI 53005

Type: Class:

Low/High rate:

AFH(262) 391-2706SUREN SIVA

4,000/6,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/20/2018

WISCONSIN LIVING LLC (THE) (0016796)

02/29/2020License Renewal Fee Due*:

29312 WASHINGTON AVEROCHESTER WI 53167(262) 534-3355 SUE KWASIGROCHCounty: RACINE

SUE KWASIGROCH

PO BOX 661ROCHESTER WI 53167

Type: Class:

Low/High rate:

AFH(262) 534-3355SUE KWASIGROCH

1,500/7,000M - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/01/2001

KWASIGROCH FAMILY CARE HOME (0009255)

07/31/2019License Renewal Fee Due*:

8917 CITADEL TERRACESTURTEVANT WI 53177(262) 886-3328 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

5,910/7,710M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 11/20/2008

ALPHA HOMES OF WISCONSIN XIX (0012193)

11/30/2018License Renewal Fee Due*:

3657 MERLIN CTSTURTEVANT WI 53177(262) 886-3328 DAVID DUFFECKCounty: RACINE

ALPHA HOMES OF WISCONSIN INC

6216 WASHINGTON AVE SUITE DRACINE WI 53406

Type: Class:

Low/High rate:

AFH(262) 886-3328DAVID DUFFECK

5,700/5,700M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/26/2005

ALPHA HOMES OF WISCONSIN XVII (0010747)

05/31/2019License Renewal Fee Due*:

3516 S KENNEDY DRSTURTEVANT WI 53177(262) 583-2113 CHINYERE UCHEGBUCounty: RACINE

CELESTIAL TOUCH HOME HEALTH CARE LLC

3516 S KENNEDY DRSTURTEVANT WI 53177

Type: Class:

Low/High rate:

AFH(262) 705-3602CHINYERE UCHEGBU

4,250/6,250M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDTERMINALLY ILL

Gender - Capacity:

Initial License: 01/25/2018

CELESTIAL TOUCH HOME HEALTH CARE LLC (0016993)

01/31/2020License Renewal Fee Due*:

9430 JASMINE CTSTURTEVANT WI 53177(414) 519-8588 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 519-8588BASHAR QEDAN

6,975M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/03/2017

OPEN ARMS 20 LLC (0016807)

07/31/2019License Renewal Fee Due*:

3648 91ST PLACESTURTEVANT WI 53177(414) 519-8588 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 519-8588BASHAR QEDAN

6,975M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/03/2017

OPEN ARMS 20 LLC (0016806)

07/31/2019License Renewal Fee Due*:

3708 91ST PLACESTURTEVANT WI 53177(414) 519-2588 LYNETTE DUKQUITSCounty: RACINE

OPEN ARMS 20 LLC

5335 TAYLOR AVEMOUNT PLEASANT WI 53403

Type: Class:

Low/High rate:

AFH(414) 915-8588BASHAR QEDAN

6,975M/F - 4

ADVANCED AGEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 08/03/2017

OPEN ARMS 20 LLC (0016805)

07/31/2019License Renewal Fee Due*:

2015 90TH STREETSTURTEVANT WI 53177(262) 598-4562 LUCY BURGESSCounty: RACINE

PRICELESS TIME ADULT FAMILY HOME LLC

1821 BLAKERACINE WI 53404

Type: Class:

Low/High rate:

AFH(262) 598-4662LUCY BURGESS

5,589/17,050M/F - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILLTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 03/16/2016

PRICELESS TIME ADULT FAMILY HOME II (0015969)

03/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 29

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

3133 BUCKINGHAM RDSTURTEVANT WI 53177(262) 497-5610 TOM HOLBUSCounty: RACINE

SERENITY CARE LLC

3133 BUCKINGHAM RDSTURTEVANT WI 53177

Type: Class:

Low/High rate:

AFH(262) 497-5610TOM HOLBUS

3,376/3,224M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 04/23/2007

SERENITY CARE LLC (0011803)

04/30/2019License Renewal Fee Due*:

6111 E WIND LAKE RDUNION GROVE WI 53182(262) 895-0113 LYNN KARLESKYCounty: RACINE

CARE AND COMFORT ADULT FAMILY HOME LLC

6111 E WIND LAKE RDUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(847) 344-9901LYNN KARLESKY

6,080/7,130M/F - 4

ADVANCED AGEDALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/13/2016

CARE AND COMFORT 2 ADULT FAMILY HOME (0016290)

11/30/2018License Renewal Fee Due*:

6109 E WIND LAKE ROADUNION GROVE WI 53182(262) 895-0152 LYNN KARLESKYCounty: RACINE

CARE AND COMFORT ADULT FAMILY HOME LLC

6109 E WIND LAKE ROADUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(847) 344-9901LYNN KARLESKY

6,080/6,080M/F - 4

ALCOHOL/DRUG DEPENDENTDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLEDPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/13/2014

CARE AND COMFORT ADULT FAMILY HOME LLC (0015063)

04/30/2020License Renewal Fee Due*:

1344 JEAN STUNION GROVE WI 53182(262) 864-4283 PENNY ADOLPHCounty: RACINE

JAMES CARES LLC

1014 VINE STUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(262) 939-3443DUSTIN SVENDSEN

3,700/5,700M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 05/10/2018

JEAN MANOR (0017128)

04/30/2020License Renewal Fee Due*:

18328 SPRING STUNION GROVE WI 53182(262) 878-3138 MARILYN A MARTINCounty: RACINE

MARILYN A MARTIN

18328 SPRING STUNION GROVE WI 53182

Type: Class:

Low/High rate:

AFH(262) 878-3138MARILYN A MARTIN

3,875/4,650M/F - 4

DEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDPUBLIC FUNDING

Gender - Capacity:

Initial License: 08/01/1998

MARTIN FAMILY CARE HOME (390199)

07/31/2018License Renewal Fee Due*:

16805 WASHINGTON AVEUNION GROVE WI 53182(262) 534-3467 GERALD & BONNIE REINEKECounty: RACINE

REINEKE CARE HOME LLC

2940 MEALY RDWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 534-3467GERALD & BONNIE REINEKE

2,000/4,400M - 4

DEVELOPMENTALLY DISABLED

Gender - Capacity:

Initial License: 06/30/2006

REINEKE CARE HOMES (0011532)

06/30/2020License Renewal Fee Due*:

106 S 3RD STREETWATERFORD WI 53185(262) 342-6928 ADRIANE NELSONCounty: RACINE

ANA LIVING LLC

3508 PENINSULA DRIVEBURLINGTON WI 53105

Type: Class:

Low/High rate:

AFH(262) 342-6928ADRIANE NELSON

4,200/5,500M/F - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPHYSICALLY DISABLED

Gender - Capacity:

Initial License: 07/27/2017

ELIZABETH III (0016724)

07/31/2019License Renewal Fee Due*:

4525 GUNDERSON RDWATERFORD WI 53185(262) 895-6666 MELINDA DOLPHINCounty: RACINE

PERSONALLY YOURS ELDER CARE LLC

4525 GUNDERSON ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 895-6666MELINDA DOLPHIN

5,000/7,000M/F - 4

ADVANCED AGEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDPUBLIC FUNDINGTERMINALLY ILL

Gender - Capacity:

Initial License: 09/04/1998

PERSONALLY YOURS ELDER CARE (390231)

09/30/2018License Renewal Fee Due*:

4525 GUNDERSON ROADWATERFORD WI 53185(262) 895-6666 MELINDA DOLPHINCounty: RACINE

PERSONALLY YOURS ELDER CARE A

4525 GUNDERSON ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(414) 750-4062MELINDA DOLPHIN

5,500/7,000M/F - 4

ADVANCED AGEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILL

Gender - Capacity:

Initial License: 03/26/2013

PERSONALLY YOURS ELDER CARE A (0014523)

03/31/2019License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.

Division of Quality AssuranceWisconsin Department of Health Services Page 30

06/25/2018Directory U d t d

Facility Name and Address Licensee Name and PhoneMailing Address

By County, City

Phone Number / Contact Person

Public Directory

Specialty Programs

For Adult Family Home Facilities

4525 GUNDERSON RDWATERFORD WI 53185(262) 895-6666 MELINDA J DOLPHINCounty: RACINE

PERSONALLY YOURS ELDER CARE B

4525 GUNDERSON ROADWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(414) 750-4062MELINDA J DOLPHIN

5,000/7,000M/F - 4

ADVANCED AGEDEMOTIONALLY DISTURBED/MENTALILLNESSIRREVERSIBLE DEMENTIA/ALZHEIMER'SPHYSICALLY DISABLEDTERMINALLY ILL

Gender - Capacity:

Initial License: 04/09/2009

PERSONALLY YOURS ELDER CARE B (0012750)

04/30/2019License Renewal Fee Due*:

6831 BIG BEND RDWATERFORD WI 53185(262) 895-6430 SUSAN RAUSCHCounty: RACINE

SUSAN RAUSCH

PO BOX 322WATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 895-6430SUSAN RAUSCH

2,858/3,561M - 3

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDING

Gender - Capacity:

Initial License: 04/30/2009

RAUSCH FAMILY CARE HOME (0012794)

04/30/2019License Renewal Fee Due*:

2940 MEALY RDWATERFORD WI 53185(262) 534-3467 BONNIE REINEKECounty: RACINE

GERALD & BONNIE REINEKE

2940 MEALY RDWATERFORD WI 53185

Type: Class:

Low/High rate:

AFH(262) 534-3467BONNIE REINEKE

1,300/4,500 - 4

DEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 12/16/2003

REINEKE HOME (0010455)

12/31/2020License Renewal Fee Due*:

26516 NORDIC RIDGE DRWIND LAKE WI 53185(262) 895-6691 PAULA HEYERCounty: RACINE

AFFINITY HEALTH CARE LLC

8208 RACINE AVEWIND LAKE WI 53185

Type: Class:

Low/High rate:

AFH(262) 895-3052THOMAS R SCHILLING

4,500/6,500M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDEMOTIONALLY DISTURBED/MENTALILLNESSPUBLIC FUNDINGTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 05/26/2009

EAGLES LANDING (0012634)

05/31/2019License Renewal Fee Due*:

314 JONSUE LANEWIND POINT WI 53402(414) 554-8280 NICOLE PFEIFERCounty: RACINE

314 JONSUE LANEWIND POINT WI 53402

Type: Class:

Low/High rate:

AFH(414) 554-8280NICOLE PFEIFER

130/400M/F - 4

ADVANCED AGEDDEVELOPMENTALLY DISABLEDPHYSICALLY DISABLEDTRAUMATIC BRAIN INJURY

Gender - Capacity:

Initial License: 02/04/2014

WIND POINT VILLA ADULT FAMILY HOME (0014859)

01/31/2020License Renewal Fee Due*:

*The Adult Family Homey (AFH) directory is updated monthly. It is possible that a facility's license renewal fee due date may appear to have passed since the directory was last updated, when in fact that facility's required fee has been paid and its license has been renewed without this being reflected on the directory.