Request for Providers

Day Program:

Date Number Type of Waiver Service Description PDF
(no records found)

HPC:

Date Number Type of Waiver Service Description PDF
Date: January 22 2020 Number: 01025 Waiver Type: Level 1 Service Desc: Download
Date: January 22 2020 Number: 01023 Waiver Type: Level 1 Service Desc: Download
Date: January 22 2020 Number: 01021 Waiver Type: SELF Service Desc: Download
Date: January 22 2020 Number: 01020 Waiver Type: Level 1 Service Desc: Download
Date: January 22 2020 Number: 01019 Waiver Type: Level 1 Service Desc: Download
Date: January 22 2020 Number: 01018 Waiver Type: IO Service Desc: Download
Date: January 17 2020 Number: 01017 Waiver Type: IO Service Desc: Download
Date: January 16 2020 Number: 01015 Waiver Type: IO Service Desc: Download
Date: January 15 2020 Number: 01045 Waiver Type: Level 1 Service Desc: Download
Date: January 15 2020 Number: 01016 Waiver Type: Level 1 Service Desc: Download

NMT:

Date Number Type of Waiver Service Description PDF
Date: January 22 2020 Number: 01024 Waiver Type: IO Service Desc: Download
Date: January 17 2020 Number: 01022 Waiver Type: Level 1 Service Desc: Download

Nursing & Other:

Date Number Type of Waiver Service Description PDF
Date: January 27 2020 Number: 01027 Waiver Type: IO Service Desc: Home modification Download
Date: January 22 2020 Number: 01026 Waiver Type: Level 1 Service Desc: Shower Stall Renovation Download