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Get CA CDPH 502 2014-2024

ONLY) California Department of Public Health (CDPH) Nursing Home Administrator Program (NHAP) P.O. Box 997416, MS 3302 Sacramento, CA 95899-7416 (916) 552-8780 FAX (916) 552-8777 NHAP@cdph.ca.gov APPLICATION FOR AIT PROGRAM Return this completed form with a check or money order (made payable to NHAP) with the appropriate fees (AIT Program Application Fee, Application Processing Fee and Live Scan Fee) to the following address: Nursing Home Administrator Program P.O. Box 997416, MS 3302 Sacrame.

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