ContractBehavioral Health Administrative Services Organization Contract • April 29th, 2021
CONTRACT AMENDMENT BEHAVIORAL HEALTH – ADMINSTRATIVE SERVICES ORGANIZATION HCA Contract No.: K4949 Amendment No.: 02 THIS AMENDMENT TO THE BEHAVIORAL HEALTH – ADMINISTRATIVE SERVICES ORGANIZATION CONTRACT is betweenthe Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAMENorth Sound Behavioral Health Organization CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS301 Valley Mall Way, Suite 110 Mount Vernon, WA 98273 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)603-583-336
ContractBehavioral Health Administrative Services Organization Contract • March 3rd, 2020
CONTRACT AMENDMENT BEHAVIORAL HEALTH – ADMINSTRATIVE SERVICES ORGANIZATION HCA Contract No.: K4159 Amendment No.: 1 THIS AMENDMENT TO THE BEHAVIORAL HEALTH – ADMINISTRATIVE SERVICES ORGANIZATION CONTRACT is betweenthe Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAMENorth Sound Behavioral Health Organization CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS301 Valley Mall Way, Suite 110 Mount Vernon, WA 98273 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)603-583-336
ContractBehavioral Health – Administrative Services Organization Contract • June 26th, 2022
CONTRACT AMENDMENT BEHAVIORAL HEALTH – ADMINSTRATIVE SERVICES ORGANIZATION HCA Contract No.: K4949 Amendment No.: 05 THIS AMENDMENT TO THE BEHAVIORAL HEALTH – ADMINISTRATIVE SERVICES ORGANIZATION CONTRACT is betweenthe Washington State Health Care Authority and the party whose name appears below, and is effective as of the date setforth below. CONTRACTOR NAMENorth Sound Behavioral Health Organization CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS2021 E. College Way, Suite 101 Mount Vernon, WA 98273 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)603-583-336
ContractBehavioral Health Administrative Services Organization Contract • November 17th, 2021
CONTRACT AMENDMENT BEHAVIORAL HEALTH – ADMINSTRATIVE SERVICES ORGANIZATION HCA Contract No.: K4949 Amendment No.: 3 THIS AMENDMENT TO THE BEHAVIORAL HEALTH – ADMINISTRATIVE SERVICES ORGANIZATION CONTRACT is betweenthe Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAMENorth Sound Behavioral Health Organization CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS2021 E. College Way, Suite 101 Mount Vernon, WA 98273 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)603-583-336
DocuSign Envelope ID: 655E5D03-0D22-4937-B60C-5CC79A394025Behavioral Health Administrative Services Organization Contract • May 11th, 2021
CONTRACT AMENDMENT BEHAVIORAL HEALTH – ADMINSTRATIVE SERVICES ORGANIZATION HCA Contract No.: K4949 Amendment No.: 1 THIS AMENDMENT TO THE BEHAVIORAL HEALTH – ADMINISTRATIVE SERVICES ORGANIZATION CONTRACT is betweenthe Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAMENorth Sound Behavioral Health Organization CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS301 Valley Mall Way, Suite 110 Mount Vernon, WA 98273 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)603-583-336
Attachment 1 – Draft Sample BH-ASO ContractBehavioral Health Administrative Services Organization Contract • March 17th, 2017 • Washington
WASHINGTON BEHAVIORAL HEALTH – ADMINISTRATIVESERVICES ORGANIZATION CONTRACT HCA Contract Number: Awarded from - This Contract is between the State of Washington Health Care Authority (HCA) and the Contractor identified below, and is governed by chapter 41.05 RCW and Title 182 WAC. CONTRACTOR NAME . CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS HCA CONTACT TELEPHONE HCA CONTACT FAXN/A HCA CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUB-RECIPIENT FOR PURPOSES OF THIS CONTRACT?No CFDA NUMBER(S) N/A CONTRACT START DATE CONTRACT END DATE MAXIMUM CONTRACT AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference:Exhibits: Attachment. The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive understanding between the parties s
ContractBehavioral Health – Administrative Services Organization Contract • June 16th, 2020
CONTRACT AMENDMENT BEHAVIORAL HEALTH – ADMINSTRATIVE SERVICES ORGANIZATION HCA Contract No.: K4159 Amendment No.: 3 THIS AMENDMENT TO THE BEHAVIORAL HEALTH – ADMINISTRATIVE SERVICES ORGANIZATION CONTRACT is betweenthe Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAMENorth Sound Behavioral Health Organization CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS301 Valley Mall Way, Suite 110 Mount Vernon, WA 98273 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)603-583-336
