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Acentra Health (formerly Kepro) fax number

(833) 522-5429

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NCLIFTSS / PASRR Local Contact Agency (LCA)

Used for: PASRR referrals and Level II evaluations for North Carolina Medicaid LTSS; Local Contact Agency referrals

Fax destination details

Department
NCLIFTSS / PASRR Local Contact Agency (LCA)
Purpose
PASRR referrals and Level II evaluations for North Carolina Medicaid LTSS; Local Contact Agency referrals
Form
LCA-Options Counseling Referral Request Form — LCA Options Counseling Referral Request Form
Address
2000 Centregreen Way, Ste 220, Cary, NC 27513, USA
Voice phone
+1 833-522-5429

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fax, email, or call to reference NC PASRR referral guidelines; Level II referrals require Level I screen completion; include facility and resident identifiers.

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