SCHOOL-BASED MEDICAID PROGRAM AMENDED AND RESTATED PROVIDER CONTRACTProvider Contract • November 24th, 2023 • Massachusetts
Contract Type FiledNovember 24th, 2023 JurisdictionThis Contract, effective is hereby amended and restated effective July 1, 2019, and is by and between the Commonwealth of Massachusetts Executive Office of Health and Human Services (hereinafter, “EOHHS”), with a business address of One Ashburton Place, Boston, Massachusetts 02108 and
SCHOOL-BASED MEDICAID PROGRAMProvider Contract • January 29th, 2019 • Massachusetts
Contract Type FiledJanuary 29th, 2019 JurisdictionThis Contract, effective is hereby amended and restated effective July 1, 2019, and is by and between the Commonwealth of Massachusetts Executive Office of Health and Human Services (hereinafter, “EOHHS”), with a business address of One Ashburton Place, Boston, Massachusetts 02108 and , (the legal name of the School- Based Medicaid Provider, hereinafter, the “Provider”) with a principal place of business located at
COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES SCHOOL-BASED MEDICAID PROGRAM AMENDED AND RESTATED PROVIDER CONTRACTProvider Contract • January 29th, 2019 • Massachusetts
Contract Type FiledJanuary 29th, 2019 JurisdictionThis Contract, effective is hereby amended and restated effective July 1, 2019, and is by and between the Commonwealth of Massachusetts Executive Office of Health and Human Services (hereinafter, “EOHHS”), with a business address of One Ashburton Place, Boston, Massachusetts 02108 and __________________________________________, (the legal name of the School-Based Medicaid Provider, hereinafter, the “Provider”) with a principal place of business located at ______________________________________________________________________________________________________________________________________________________________ [Provider’s address].