Common Contracts
2 similar Organizational Provider Agreement contracts
ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTYOrganizational Provider Agreement • April 14th, 2022
This Contract is entered into on __________________ “Contract Date” between the Mental Health Plan of _____________ hereinafter referred to as MHP and ______________________, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of ________________ and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.
ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTYOrganizational Provider Agreement • September 16th, 2020
This Contract is entered into on __________________ “Contract Date” between the Mental Health Plan of _____________ hereinafter referred to as MHP and ______________________, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of ________________ and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.
