Arizona Administrative Code
Title 6 - ECONOMIC SECURITY
Chapter 6 - DEPARTMENT OF ECONOMIC SECURITY - DEVELOPMENTAL DISABILITIES
Article 15 - STANDARDS FOR CERTIFICATION OF HOME AND COMMUNITY-BASED SERVICE (HCBS) PROVIDERS
Section R6-6-1507 - Application for an Hcbs Certificate Renewal

Universal Citation: AZ Admin Code R 6-6-1507

Current through Register Vol. 30, No. 12, March 22, 2024

A. The Division shall send a notice of renewal to the service provider 60 days prior to the expiration of the HCBS certificate.

B. Not more than 30 days and not less than 10 days prior to the expiration date of a current HCBS certificate, an applicant shall apply to the Division for renewal on a form provided and prescribed by the Division. The form shall contain the following information:

1. Name;

2. Home and business address;

3. Social security number or tax identification number;

4. AHCCCS registration number;

5. Phone number; and

6. Any services which the applicant wishes to:
a. Provide in addition to services currently on the HCBS certificate; or

b. Delete from services currently on the HCBS certificate.

C. The applicant shall include a copy of current licenses and training as required by this Article.

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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