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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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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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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232