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Enter the contact information of the person you want the DHCS to contact regarding this application. 11a. Name Enter the name of the contactperson. 11b. 2. Chief Executive Officer This box must contain the first and last name of the corporation or LLC/LLP Chief Executive Officer. Site specific National Provider Identification NPI number if any If you answered yes to 2 above you must enter your NPI number. Program Name Address License Number Zip City Address administrative/executive staff board...

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all of the slides that you'll be seeing today will be available on cch eyes website as well as the recording that we're making of today's webinar so that will be posted on our best practices session series for you to look at later or to listen to we decided to do this webinar with DHCS and covered California because we heard so many questions and some concerns from community-based organizations and outreach and enrollment entities about the process of becoming a certified enrollment entity and the training program for certified enrollment counselors under covered California we wanted to have an opportunity to address those and as well we heard a lot of questions about the future of the ca a program that has now shifted over to the Department of Health Care Services so we wanted to make sure that we have an opportunity to talk about that as well so to help us understand all of these and other issues that we'll be talking about today there we have with us today g-wagen deputy director of

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Quick guide on how to complete initial treatment provider application substance abuse clinics dhcs 6002 rev 0616 initial treatment provider application

How to fill out the Initial Treatment Provider Application Substance Abuse Clinics DHCS 6002 REV. 06/16. Initial Treatment Provider Application Substance Abuse Clinics - dhcs ca form on the web:

Create this formin 5 minutes or less

Video instructions and help with filling out and completing Dhcs 6002Form

Instructions and help about Dhcs 6002

Related searches to Dhcs 6002

How to create an e-signature for the initial treatment provider application substance abuse clinics dhcs 6002 rev 0616 initial treatment provider application

How to create an electronic signature for your Initial Treatment Provider Application Substance Abuse Clinics Dhcs 6002 Rev 0616 Initial Treatment Provider Application in the online mode

How to generate an e-signature for your Initial Treatment Provider Application Substance Abuse Clinics Dhcs 6002 Rev 0616 Initial Treatment Provider Application in Chrome

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Quick guide on how to complete initial treatment provider application substance abuse clinics dhcs 6002 rev 0616 initial treatment provider application

How to fill out the Initial Treatment Provider Application Substance Abuse Clinics DHCS 6002 REV. 06/16. Initial Treatment Provider Application Substance Abuse Clinics - dhcs ca form on the web:

Create this formin 5 minutes or less

Video instructions and help with filling out and completing Dhcs 6002Form

Instructions and help about Dhcs 6002

Related searches to Dhcs 6002

How to create an e-signature for the initial treatment provider application substance abuse clinics dhcs 6002 rev 0616 initial treatment provider application

How to create an electronic signature for your Initial Treatment Provider Application Substance Abuse Clinics Dhcs 6002 Rev 0616 Initial Treatment Provider Application in the online mode

How to generate an e-signature for your Initial Treatment Provider Application Substance Abuse Clinics Dhcs 6002 Rev 0616 Initial Treatment Provider Application in Chrome

How to make an electronic signature for signing the Initial Treatment Provider Application Substance Abuse Clinics Dhcs 6002 Rev 0616 Initial Treatment Provider Application in Gmail

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