The Agency for Health Care Administration / Agency for Persons / Agency for Health Care Administration Case / AGENCY FOR HEALTH CARE ADMINISTRATION HOSPITAL / Profit Corporation Limited Liability Company Partnership / /
Department of State / Department of Financial Services / State Division of Corporations / Commission on Accreditation / Commission on Accreditation of Rehabilitation Facilities / Licensee AUTHORITY / National Committee for Quality Assurance / DCF Children’s Mental Health Office / officers of Licensee / Residential Treatment Center / Outpatient Services Unit / Department of Health / C. D. Center / Division of Corporations / Council on Accreditation / Medicare / / /
Position
Financial Officer / board member / Administrator and Financial Officer / Administrator / Director BUSINESS ADDRESS TELEPHONE NUMBER /CEO President Vice President Secretary Treasurer / authorized representative / Representative / officer / Florida Secretary / NAME TELEHPONE NUMBER E-MAIL Administrator/Managing Employee Financial Officer / /
APPLICATION CHECKLIST Health Care Licensing Application RESIDENTIAL TREATMENT CENTERS For CHILDREN AND ADOLESCENTS Applicants must include the following attachments as stated in Chapters 408, Part II, and 394, Florida St