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Location Manager
Name/Description:
Branch/Contract
select
--Select Branch/Contract
Active
Type:
select
--Select One--
Daily Living Supports (Non Texas)
Day Habilitation
Foster/Companion Care (Fc)
Group Homes (Rss)
Icf
Other
Own Home/Family Home (Ohfh)
Supervised Living (Sl)
Texas Home Living (Txhml)
Traditional Group Home (Non Texas)
Location Code:
Staff Performing Residential Review:
select
Staff Approving Residential Review:
select
Address:
City/St/Zip:
County:
Phone No.:
IP Address:
Location Supervisor
Residential Site Review