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Get Title 19 Waiver Wv

Unique identifier will be pre-filled and cannot be modified and must be accurately submitted via EDI. (3.) Provider Requesting Transfer Provider ID: (TransFrom SC Provider ID) This is the transferring Service Coordination APS assigned Provider ID, if applicable. This number is typically the behavioral health license number (for licensed behavioral health centers) or Medicaid assigned provider number. This number is unique for each Provider. This field will be blank if the service coordination a.

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