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Get Agency Credentialing Application - Ct.gov - Ct

And EMPOWERMENT (WISE) Agency Name: Return all requested material to: Advanced Behavioral Health, Inc. 213 Court Street Middletown, CT 06457 Attn: Kristie Scott, Program Manager Please remember to make a copy of all documentation submitted. The Agency is Applying for Participation to Provide the Following Services: Check all that apply: Assertive Community Treatment-RFP awarded agencies only Community Support Program Peer Support- Not currently open for Short Term Crisis Stabilization Suppo.

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