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Initial Provider Application - Virginia Department of Behavioral ... - dbhds virginia 2025

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The document is an application form for licensing providers by the Virginia Department of Behavioral Health and Developmental Services. It outlines the necessary information required from applicants, including organizational details, service types, and required attachments for various behavioral health and developmental services. The application must be completed by a responsible individual within the organization and includes sections for applicant information, organizational structure, service descriptions, client demographics, and compliance with regulations.

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What is the purpose of the Initial Provider Application for Licensing?

The application is used to lawfully establish, conduct, and provide behavioral health and developmental services in Virginia.

Who should complete the application?

The application should be completed by the chief executive officer, director, or another authorized member of the governing body responsible for maintaining standards and policies.

What information is required in the Applicant Information section?

You need to provide details such as organization name, mailing address, contact information, and names of all owners with their ownership percentages.

How do I identify the organizational structure of my agency?

You can check one of the provided options such as Non-Profit, For-Profit, Individual (proprietorship), Corporation, Partnership, or Unincorporated Organization.

What types of services can I apply for?

New applicants are permitted to apply for ONE service on the initial application from a list that includes various residential and outpatient services for different populations.

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Initial Provider Application - Virginia Department of Behavioral ... - dbhds virginia 2025

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What is the purpose of the Initial Provider Application for Licensing?

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What information is required in the Applicant Information section?

How do I identify the organizational structure of my agency?

What types of services can I apply for?

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How do I start a group home in Virginia?

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