Community Services Licensure and Certification

Community Services Licensure and Certification

The Office of Community Services issues and regulates licenses and certifications for a variety of provider-types. Please review the manual for the provider type that you are interested in on our rules page.

A list of applications can be found below and can be submitted to DPSQA.ProviderApplications@dhs.arkansas.gov.

Completed applications are entered in to our work queue and assigned to a specialist within 2 business days. Some manuals will outline timeframes for processing as well as requirements of what should be sent with an application. Additionally, those who want to enroll as a provider to Medicaid clients also should understand these licenses and certifications are only part of the prerequisites to the Medicaid Provider Enrollment process.

Please review the information on our page about becoming a Medicaid provider for more information. If you have any questions about applying, your application, or the regulating of an already issued license/certification, please contact us so that we may review your concerns.

Applications

Adult Day Care (ADC)
Adult Developmental Day Treatment (ADDT)
Adult Day Health Care (ADHC)
ARChoices Provider Certification Application
Assisted Living Facility (ALF)
Community Support Systems Provider
Early Intervention Day Treatment (EIDT)
Independently Licensed Practitioner (ILP)
Partial Hospitalization
Post Acute Head Injury (PAHI)
Residential Care Facility (RCF)
Targeted Case Management Provider Application
Therapeutic Communities

Forms

BHA Accreditation Release Form 200
BHA Adding New Site Certification Form 250
BHA Notification Form 220
BHA Summary Form 210
SA Licensure Site Information

Rules

Division of Provider Services & Quality Assurance – Rules

DPSQA Address

700 Main Street Slot S-427
Little Rock, AR  72203-1437 

DPSQA Phone Number

501-682-2441

Learn About Programs

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