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Managing Mental Health, Intellectual/Developmental Disabilities and Substance Abuse Services 9106739111 (FAX) 9106736202 www.sandhillscenter.org Victoria White, Provider Agency/Facility Application

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Who needs provider agencyfacility application for?

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Provider agencies or facilities seeking to be recognized or licensed by the appropriate governing body.

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What is provider agency/facility application for?

The provider agency/facility application is for registering and establishing agencies or facilities that provide services to clients in need.

Who is required to file provider agency/facility application for?

Any individual or organization looking to operate as a provider agency or facility must file the application.

How to fill out provider agency/facility application for?

The application must be completed with accurate information regarding the agency/facility, services offered, and compliance with regulations.

What is the purpose of provider agency/facility application for?

The purpose of the application is to ensure that agencies and facilities meet standards and regulations to provide safe and quality services to clients.

What information must be reported on provider agency/facility application for?

Information such as agency/facility details, services offered, staff qualifications, and compliance with regulations must be reported on the application.

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