Health Facilities Licensure Program 

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New Provider Packets

New providers must request a new provider packet from Health Facility Services.  This packet will contain all required packet from Health Facility Services. This packet will contain all required forms to start the process to become Licensed and/or Medicare Certified.

  • Hospitals
  • Home Health Agencies
  • Hospices
  • Outpatient Surgery Centers/Ambulatory Surgery Center
  • Psychiatric Hospitals
  • Rehabilitation Hospitals
  • Abortion Clinics
  • Alcohol/Drug Abuse Units
  • Free-Standing Birthing Centers
  • Invitro Fertilization Facilities
  • Infirmaries
  • Private Care Agencies
  • Recuperation Centers
  • Outpatient Psychiatric Centers

Change of Ownership Packets

  • Hospitals
  • Home Health Agencies
  • Hospices
  • Outpatient Surgery Centers/Ambulatory Surgery Center
  • Psychiatric Hospitals
  • Rehabilitation Hospitals
  • Abortion Clinics
  • Alcohol/Drug Abuse Units
  • Free-Standing Birthing Centers
  • Invitro Fertilization Facilities
  • Infirmaries
  • Private Care Agencies
  • Recuperation Centers
  • Outpatient Psychiatric Centers

Request for New Provider Packets or Change of Ownership Packets should be submitted via mail, or fax. Please be sure to identify which type of provider packet(s) is required.

OfficeAddressPhoneFax
Health Facility Services5800 W. 10th Street, Suite 400
Little Rock, AR 72204
501-661-2201501-661-2165