ContractWashington Apple Health Expansion Care Contract • June 12th, 2024 • Washington
Washington Apple Health Expansion Care Contract HCA Contract Number:«Contract» THIS CONTRACT is made by and between the Washington State Health Care Authority (“HCA”) and the party whose name appears below ("Contractor"). CONTRACTOR NAME«Organization_Name» CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS«City», «State» «Zip_Code» WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) UBI» HCA INDEX NUMBER CONTRACTOR CONTACT«Contact_Fname» «Contact_LName» CONTRACTOR TELEPHONE«PhoneNo» CONTRACTOR E-MAIL ADDRESS«EmailAddress» HCA PROGRAMMedicaid Contracts Unit HCA DIVISION/SECTIONMedicaid Programs Division/Apple Health Expansion HCA CONTACT NAME AND TITLEAngela CastroAHE Contract Manager HCA CONTACT ADDRESS PO Box 45530Olympia, WA 98504-5502 HCA CONTACT TELEPHONE 360-725-9703 HCA CONTACT E-MAIL ADDRESSangela.castro@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT?YES NO CFDA NUMBER(S); ; ; CONTRACT START DATEJuly 1, 2024 CONTRACT END DATEDecember 31, 2025 PRIOR MAXIM
