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1: 04/01/2019 : Zipped Fee Schedules - 2018: ZIP: 17250
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Contact Info: 122 W 25th St
To make this transition ODM will not be accepting new provider enrollment applications or continue any in-progress enrollment applications through the MITS Provider Enrollment System and portal, tentatively starting August 1, 2022, with a firm date to be announced
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QI-2167 - Community Care
Select Livescan Provider and Make Appointment In accordance with section 408
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809(3), Florida Statutes, all Level 2 screenings must be submitted
Active Medicaid Program Codes: Appendix A-14: Life Expectancy Table: Appendix A-16: Certification of Prior Residence: Appendix A-17: Life Estate and Remainder Interest Table: Appendix A-22: Qualified Medicaid Trust Guidelines and Forms: Appendix A-22