Provider Applications
To submit an application to enroll as a provider for the HOME Choice program, please review the options below. Locate the service you would like to provide, and then select whether you are an agency or an independent provider (non-agency). Once you select your provider type, please print, read, complete, and sign all of the documents contained under that link. After you have signed the documents, please mail them to the address below. A checklist has been provided to ensure that you have included all the necessary documents. Incomplete applications cannot be accepted. In addition, online applications are not accepted.
Mail your application documents to:
HOME Choice Provider Enrollment
P.O. Box 182709
Columbus, OH 43218
Have questions?
Call 1-888-221-1560 and ask for HOME Choice Provider Enrollment.
| Service | Agency? | Non-Agency? |
| HOME Choice Nursing (description) | Yes | Yes |
| Independent Living Skills Training (description) | Yes | No |
| Community Support Coaching (description) | Yes | Yes |
| Social Work/Counseling (description) | Yes | Yes |
| Nutritional Consultation (description) | Yes | Yes |
| Communication Aids (description) | Yes | No |
| Service Animals (description) | Yes | No |