Form 3207, Chemical Dependency Treatment Facility License Application

Instructions

Updated: 11/2022

Purpose

Form 3207 is used to apply for a new or change in status license for a chemical dependency treatment facility.

Information regarding licensure for chemical dependency treatment facilities is located on the HHSC Chemical Dependency Treatment Facility page.

For Health Care Regulation contact information, visit the Health Care Facilities Regulation Contact Us page.

Procedure

When to Prepare

New Applicant

To apply for licensure, an applicant must submit all the following:

• A completed Form 3207, Chemical Dependency Treatment Facility License Application
• License fee
• Completed Form 3208, Chemical Dependency Treatment Facility License Application Checklist for Initial Applicants
• Supplemental documentation, as required by Texas Administrative Code Title 25 (25 TAC) Section 448.401 License Required and Section 448.403(a-h), New Licensure Application

Per 25 TAC Section 448.401(c), chemical dependency treatment facility licenses are non-transferable and do not have a change of ownership application process. When a new entity purchases an existing licensed facility and the purchase affects the legal name and Federal Tax ID, the existing licensed provider must submit a closure form and relinquish the license. The new entity must apply as a new applicant and go through the initial application process.

Currently Licensed Applicant

To apply for change in status license, an applicant must submit all the following:

• A completed Form 3207, Chemical Dependency Treatment Facility License Application
• Applicable license fees
• Completed Form 3208, Chemical Dependency Treatment Facility License Application Checklist for Initial Applicants
• Applicable supplemental documents, as required by 25 TAC Section 448.401, License Required and Section 448.405(a-d), Change in Status.

HHSC will process a change in address (site move) as a new site.

To update information on the clinical program director, facility contact, email or phone number, submit the request to HHSC on the company letterhead, signed by the chief executive officer (CEO). The facility may submit the request to the Health Facility Licensing unit by mail, fax, or email. For Health Facility Licensing contact information, please visit the Health Care Facilities Regulation Contact Us page.

Important Items to Note

• Per Section 448.401(b), the facility must have a license for each physical location where the facility provides residential or outpatient services.
• The legal name and Federal Employment Identification Number (FEIN) on the application must reflect the legal name and FEIN as it is filed with the Internal Revenue Service (IRS).
• The Assumed Name or Doing Business As (DBA) provided on the application must reflect exactly as it is filed with the Texas Secretary of State’s Office or applicable county clerk’s office, or both.

Mailing Address for Applications with Fees

HHSC AR MC1470
P.O. Box 149055
Austin, TX 78714-9055

Overnight Address for Applications with Fees

HHSC AR MC1470
4601 W. Guadalupe Street
Austin, TX 78751

Mailing Address for Applications Without Fees

HHSC
Health Facility Licensing
Mail Code 1868
P.O. Box 149347
Austin, TX 78714-9347