Specialty Mental Health Services Provider Certification and Recertification
Avisos y cartas de información sobre salud conductual
10-04: MHP Self-certification Letter.pdf
Formularios de certificación
DHCS 1735 Formulario de transmisión de certificación de Medi-Cal | Vídeo de formación
La finalidad de la transmisión es solicitar las siguientes operaciones:
County-owned and operated provider – activate mode(s) or service, termination of a mode(s) or all services, address change and name change.
Contracted provider – activate a new provider, activate a mode(s) of service, and terminate mode(s) or all services, recertification, address change and name change.
Formulario de Solicitud de Certificación DHCS 1736 Propiedad y Operación del Condado | Vídeo de formación
The purpose of the form is for the County to submit an application for a new county-owned and operated provider.
DHCS 1737 County-Owned and Operated Provider Self-Survey Form | Training Video
The purpose of the Self-Survey Form is for the recertification of a county-owned and operated provider.
Recursos
Información de contacto
División de Revisión de Contratos y Inscripciones (CERD)
Department of Health Care Services
1500 Capitol Avenue, MS 2303
Apartado de correos 997413
Sacramento, CA 95899-7413
Email: DMHCertification@DHCS.CA.GOV