Get Ky Application For License To Operate A Non-hospital - Based Alcohol And Other Drug Treatment 2018-2025

Filling out the KY Application For License To Operate A Non-Hospital - Based Alcohol And Other Drug Treatment is an essential step in establishing a licensed treatment facility. This guide provides a clear and detailed walkthrough of the application process to help users navigate it with confidence.

Follow the steps to complete your application online.

1. Click 'Get Form' button to access the form and open it in your digital editor.
2. Begin by selecting the type of application you are submitting. Choose from options such as initial licensure, annual re-licensure, change of name, change of location, change of ownership, or addition/change in service.
3. Indicate the type of services you will provide by checking all applicable boxes. Options include outpatient treatment, intensive outpatient treatment, and various types of residential treatment.
4. Complete the identification section by providing the name of the facility, its physical address, mailing address (if different), telephone number, and primary contact email address.
5. Fill in the administrator's name and the dates when the facility began operating at the current address and under the current ownership.
6. In the control section, select the appropriate state and county, and indicate the profit status and type of ownership (individual, nonprofit, partnership, corporation, etc.).
7. Provide the name and address of the direct owner of the facility. Ensure to include details for any persons or legal entities having ownership interest, as well as contact information for corporate officers if applicable.
8. If applicable, state the number of existing outpatient extension sites and indicate if you are requesting a new extension site. Provide detailed location information for any extension sites on an attachment.
9. For initial licensure or changes in location, submit the Fire Marshal's approval documentation. Remember that this should be current within the last twelve months.
10. Ensure to sign and date the application in the signature section. Indicate your title, and remember that the application may be returned if incomplete or if the applicable fee is not submitted.
11. Submit the completed application, required fee, and any supporting documentation to the designated office.

Complete your application online now to ensure your facility is licensed to operate legally.