Delaware Provider Renewal Application

State:
Delaware
Control #:
DE-BS-13
Format:
PDF
Instant download
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Description

Provider Renewal Application The Delaware Provider Renewal Application is a form used by providers in the state of Delaware to renew their license or registration with the Delaware Department of Health and Social Services. This application must be completed and submitted to the Division of Long Term Care Residents Protection for review and approval. There are two types of Delaware Provider Renewal Application: the Standard License/Registration Renewal Application and the Facility-Based License/Registration Renewal Application. The Standard License/Registration Renewal Application is used by providers who wish to renew their license or registration with the Delaware Department of Health and Social Services. This application requires the provider to submit their current license/registration documentation, proof of completion of the required continuing education, and the applicable fee. The Facility-Based License/Registration Renewal Application is used to apply for a license or registration at a facility-based location. This application requires the provider to submit their current license/registration documentation, proof of completion of the required continuing education, and the applicable fee, as well as a list of all personnel who will be providing services in the facility.

The Delaware Provider Renewal Application is a form used by providers in the state of Delaware to renew their license or registration with the Delaware Department of Health and Social Services. This application must be completed and submitted to the Division of Long Term Care Residents Protection for review and approval. There are two types of Delaware Provider Renewal Application: the Standard License/Registration Renewal Application and the Facility-Based License/Registration Renewal Application. The Standard License/Registration Renewal Application is used by providers who wish to renew their license or registration with the Delaware Department of Health and Social Services. This application requires the provider to submit their current license/registration documentation, proof of completion of the required continuing education, and the applicable fee. The Facility-Based License/Registration Renewal Application is used to apply for a license or registration at a facility-based location. This application requires the provider to submit their current license/registration documentation, proof of completion of the required continuing education, and the applicable fee, as well as a list of all personnel who will be providing services in the facility.

How to fill out Delaware Provider Renewal Application?

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Delaware Provider Renewal Application