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INSTRUCTIONS FOR COMPLETING AN APPLICATION FOR CERTIFICATION OF A BRANCH SITE OF A CERTIFIED CHEMICAL DEPENDENCY SERVICE PROVIDER INTRODUCTION Provider certification is mandated by state laws Revised Codes of Washington RCW when a provider intends to Contract with DSHS for the provision of chemical dependency treatment services as required by RCW 70. 96A. 045 Represent itself as a state-certified chemical dependency treatment agency RCW 70. 96A. 090 prohibits treatment programs from...
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How to fill out Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider
01
Begin by downloading the Application for Certification of a Branch Site form from the official website.
02
Fill out the applicant's information, including the name of the main service provider and the branch site address.
03
Provide details about the services to be offered at the branch site.
04
Include the qualifications and experience of the staff who will be working at the branch.
05
Attach proof of compliance with local regulations and licensing requirements.
06
Fill out the financial information required to demonstrate the branch’s sustainability.
07
Review the completed application for accuracy and completeness.
08
Submit the application along with any required fees to the designated certification authority.
Who needs Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider?
01
Organizations that operate a certified chemical dependency service provider and wish to open a branch site.
02
Providers seeking to expand their services geographically to better serve clients.
03
Entities requiring formal recognition to provide chemical dependency services at a new location.
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What is Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider?
The Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider is a formal document that organizations need to submit to obtain certification for a branch location that offers chemical dependency services.
Who is required to file Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider?
Any organization that operates a certified chemical dependency service provider and wishes to establish a branch site must file this application.
How to fill out Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider?
To fill out the application, organizations must provide detailed information about the branch site, including its location, services offered, staffing, and compliance with relevant regulations. They should follow the specific instructions provided by the certifying authority.
What is the purpose of Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider?
The purpose of this application is to ensure that branch sites meet the necessary standards and regulations for providing chemical dependency services, thereby ensuring quality care for patients.
What information must be reported on Application for Certification of a Branch Site of a Certified Chemical Dependency Service Provider?
The application must report information such as the branch site address, contact details, type of services to be provided, staffing credentials, and evidence of compliance with applicable health and safety regulations.
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