Authorization Number : 490-0201
Agency Series No. : 10000005
Status : Active
Agency Web Link :
Agency : AGE
Confidential Description : Contains federal tax ID numbers, Social Security numbers and financial information.
Division : AGEDCL
Vital Description :
Section :
Record Title : Choices Waiver
Revision : 1
Record Description : Files contain completed state and federal forms that are required for an entity to become a certified Choices Waiver provider. The forms contain confidential information such as Social Security numbers, Medicaid ID numbers, federal ID numbers, and business/company information such as financial information.