Provider Index > Bridges to Health Waiver (B2H)
Provider Enrollment & Maintenance
Provides services to children in foster care who have significant mental health, developmental disabilities or health care needs to help them to live in a home or community-based setting.
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