Common Contracts

PROVIDER ENROLLMENT AGREEMENT TERMS OF AGREEMENT

Provider Enrollment Agreement • August 28th, 2018 • Michigan

• Contract Type
  Provider Enrollment Agreement
• Filed
  August 28th, 2018
• Jurisdiction
  Michigan

This Agreement is between _________________, hereinafter referred to as “Provider,” and Region B3 Area Agency on Aging DBA CareWell Services SW, 200 W. Michigan Ave, Suite 102, Battle Creek, MI 49017, herein referred to as “Waiver Agent.”