Provider Index > Assisted Living Program (ALP)
Provider Enrollment & Maintenance
Serves persons, medically eligible for nursing home placement, in a less medically intensive, lower-cost setting. Persons with Medicaid coverage must have their ALP services approved in advance by their Local Social Services District.
Complete this Enrollment Form if you are: - Applying for initial ENROLLMENT or ALREADY ENROLLED and enrolling another NPI, or
- Responding to a letter instructing you to REVALIDATE your enrollment, or
- Seeking REINSTATEMENT or REACTIVATION of your previous enrollment, or
- Reporting an OWNERSHIP CHANGE, or
- Reporting a RECEIVERSHIP
INSTITUTION Enrollment Form