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Form DHS-6189B-ENG Alternative Care (Ac) Nutrition Services Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-6189B-ENG?
This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DHS-6189B-ENG form?
A: The DHS-6189B-ENG form is the Alternative Care (AC) Nutrition Services ProviderAssurance Statement.
Q: What does the form pertain to?
A: The form pertains to the Minnesota Health Care Programs (MHCP) in Minnesota.
Q: Who is required to fill out this form?
A: Nutrition services providers participating in the Alternative Care (AC) program are required to fill out this form.
Q: What is the purpose of this form?
A: The purpose of this form is to ensure that nutrition services providers comply with the requirements of the Minnesota Health Care Programs (MHCP).
Form Details:
- Released on August 1, 2021;
- The latest edition provided by the Minnesota Department of Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHS-6189B-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
Download Form DHS-6189B-ENG Alternative Care (Ac) Nutrition Services Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
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