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Alexandria Department of Community and Human Services (Local Department of Social Services for the City of Alexandria, VA) fax number

(571) 222-1087

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Department of Community and Human Services (DCHS) – Alexandria; Local Department of Social Services (LDSS) for Alexandria City

Used for: LDSS Eligibility Fax for Completed PAS DMAS-96 (DMAS-96: Medicaid-Funded Long-Term Services and Supports Authorization) submissions and related eligibility communications.

Fax destination details

Department
Department of Community and Human Services (DCHS) – Alexandria; Local Department of Social Services (LDSS) for Alexandria City
Purpose
LDSS Eligibility Fax for Completed PAS DMAS-96 (DMAS-96: Medicaid-Funded Long-Term Services and Supports Authorization) submissions and related eligibility communications.
Form
DMAS-96 — Medicaid-Funded Long-Term Services and Supports Authorization Form (DMAS-96)
Address
4850 Mark Center Dr, Alexandria, VA 22311

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LTSS screenings use DMAS-95/DMAS-96/DMAS-97 as applicable; DMAS-96 instructions cover completing the LTSS authorization for Medicaid-funded services and submitting via official channels.

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