Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Arizona Health Care Cost Containment System (AHCCCS). Before sending anything sensitive, confirm the number and receiving department directly with Arizona Health Care Cost Containment System (AHCCCS), and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.
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Arizona Health Care Cost Containment System (AHCCCS) fax number
(888) 507-3313
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Centralized Support Unit (AHCCCS ALTCS)
Used for: ALTCS (Arizona Long Term Care Services) application submission using DE-101 (Request for Application for ALTCS).
Fax destination details
- Department
- Centralized Support Unit (AHCCCS ALTCS)
- Purpose
- ALTCS (Arizona Long Term Care Services) application submission using DE-101 (Request for Application for ALTCS).
- Form
- DE-101 (07/2019) — Request for Application for Arizona Long Term Care Services (ALTCS)
- Address
- Centralized Support Unit, 801 East Jefferson MD 3900, Phoenix, AZ 85034
- Voice phone
- 602-417-6600
- Website
- Visit organization website
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.
Fill the DE-101 form with applicant and authorized representative information and return via mail, fax to 1-888-507-3313, or take to a local ALTCS office as listed.
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