Florida Assisted Living Facility Notification of Change of Administrator AHCA Form 3180-1006
Form Template
In accordance with Florida Statutes, each assisted living facility must identify the administrator of the facility and each long-term care facility that he/she currently operates.
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The law also requires the collection of the administrator’s social security number. The Florida Assisted Living Facility Notification of Change of Administrator AHCA Form 3180-1006 app makes it simple for assisted living facility administrators to submit the required information for review. The app features sections: facility information and new administrator personal information. The app is easy to fill out, simple to edit, and convenient to save for records.
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