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  • Universal Pnmi Referral/application Form

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________________________________________________________________________________________ Does the consumer have a Rep Payee? Â… Yes Â… No If yes, contact first and last name: _________________________________ Rep Payee Telephone Number: ______________________ Does the consumer have a case manager? Â… Yes Â… No If yes, case manager first and last name:______________________________________________________ Case Management Agency and Telephone Number: ___________________________________________ Doe.

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Related content

PNMI | OMS | Maine DHHS - Maine.gov
MaineCare Services. An Office of the Maine Department of Health and Human Services. DHHS...
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A Private Non-Medical Institution (PNMI) is defined as an agency or facility that is not, as a matter of regular business, a health insuring organization, hospital, nursing home, or a community health care center, that provides food, shelter, personal care, and treatment services to four or more residents in single or ...

Private non-medical institution (PNMI): a MaineCare provider that is required to meet special requirements to provide either Community Supports or Residential Services. This may include supported housing, residential programs, or intensive in-home services.

Non-medical institutions include jails, prisons, and community residence facilities. Other institutions may also be non-medical.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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