Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Division of Developmental Disabilities (DDD), Arizona Department of Economic Security (DES) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Division of Developmental Disabilities (DDD), Arizona Department of Economic Security (DES) fax number

(602) 277-0026

Office of Administrative Review

Used for: State Fair Hearing written request for an appeal of ALTCS/Notice of Decision; include Re: Request for State Fair Hearing, DDD Appeal Number, Member Name and AHCCCS ID

Fax destination details

Department
Office of Administrative Review
Purpose
State Fair Hearing written request for an appeal of ALTCS/Notice of Decision; include Re: Request for State Fair Hearing, DDD Appeal Number, Member Name and AHCCCS ID
Form
State Fair Hearing request — Request for State Fair Hearing
Address
4000 North Central Avenue, 3rd Floor, Suite 301 - Mail Drop 2HE5, Phoenix, Arizona 85012
Voice phone
602-771-8163

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  • Check the organization website or call its main line for the current fax number.
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In the written request, reference 'Re: Request for State Fair Hearing', include the DDD Appeal Number, and the Member Name and AHCCCS ID. Submissions may be mailed, emailed, or faxed to the Office of Administrative Review.

Official form instructions are published as a downloadable file on the organization's website.

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