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Effective Date of the Transaction Add Change Close month day year Resource Identification Number (Use on change/close transactions only) SECTION 1 PROVIDER S NAME (Please Note: If you are reporting income with a Social Security Number, use your name here not the name of your business. If you are reporting income with an Employer Identification Number, use your business name here.) DOING BUSINESS AS (DBA) Complete this line only if you report income to the IRS under your Social Security.

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How to fill out the Nh Dhhs Child Care Provider Link Form online

Filling out the Nh Dhhs Child Care Provider Link Form online is essential for anyone looking to provide child care services in New Hampshire. This guide will walk you through the various sections of the form, ensuring that you complete it accurately and efficiently.

Follow the steps to complete the form online.

  1. Click the ‘Get Form’ button to retrieve the form and open it in your preferred digital document management tool.
  2. In the transaction code section, select one option by checking the corresponding box: 'Add' for new enrollment, 'Change' for reporting changes, or 'Close' to request an end to your enrollment.
  3. Enter the effective date of the transaction in the provided fields for month, day, and year to indicate when your enrollment or changes will take effect.
  4. If you have a Resource Identification Number, provide it here; this is particularly needed for changes or closures.
  5. Complete Section 1 by entering your name if reporting income under your Social Security Number. If using an Employer Identification Number, enter your business name instead.
  6. Fill out the 'Doing Business As' (DBA) line only if reporting income with your Social Security Number and having a business name. Complete your name above in this case.
  7. In Section 2, fill out your physical address, including street, town/city, state, and zip code. Also enter your billing or mailing address as payments will be directed there.
  8. Provide your email address and contact person’s details, including their first and last name and telephone number.
  9. In Section 3, indicate the type of child care service you provide by checking the appropriate box.
  10. After reviewing and confirming that all required fields are accurately completed, save your changes. You can then download, print, or share the completed form as needed.

Begin the process of completing the Nh Dhhs Child Care Provider Link Form online today!

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If any changes are required to ERA enrollment information, the Provider will contact Provider Relations call center at 866-291-1674.

No more than 8 children may be in care at one time, including the providers' children under age 7 and any additional children above age 7. Licensed providers must have 40 hours of Early Childhood training and complete 15 additional training hours annually.

Types of Licensed Child Care In a family child care home one provider may care for a maximum of 6 preschool children plus up to 3 children who are enrolled in a full-day school program. The number of children younger than 36 months of age and 24 months of age that may be cared for is limited.

To enroll as a NH Medicaid provider, visit the New Hampshire MMIS Health Enterprise Portal and click on Provider in the upper left of the page. Click on Enrollment to open the online enrollment application.

nursery, group child care center, ... programs shall be at least 18 years of age, have a high school diploma or equivalent, have a minimum of 1,000. ... A minimum of 1,500 hours of supervised experience in a licensed program or public or private elementary. ... care programs shall: ... and one of the following:

​In Nebraska, a person may operate child care for three or fewer children without having a license issued by the department. Anyone who provides child care to four or more children from different families must be licensed as a child care provider.

License Exempt (LE) Providers. In the state of New Hampshire, an individual can provide care in their home for up to three (3) children, other than their own and be a License-Exempt Provider.

Contact Information Email Address: CCLUoffice@dhhs.nh.gov. Phone: 603-271-9025. Alternate Phone: 1-800-852-3345, ext. 9025. Fax: 603-271-4782.

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