Geographic Address Change Process
Please submit the following to complete this process:
- a “letter of intent” describing the specifics of the change (address changed from and to) that has occurred and the effective date of that change;
- a completed license application (Form);
- the fee of $250 (plus $250 for each offsite location) (Payment Procedure);
- a copy of the approval letter of the architectural facility plans from the Office of the State Fire Marshal (OSFM) Health Care licensing plan review internet site - http://sfm.dps.louisiana.gov/pr_healthcare.htm OSFM plan review contact information: Phone 225-925-4920 or Fax 225-925-4414
- a copy of the on-site inspection report with approval for occupancy by the Office of the State Fire Marshall (residential and outpatient facilities only)
- a copy of the health inspection report with approval of occupancy from the Office of Public Health (residential and outpatient facilities only);
- disclosure of ownership and control information; and
- a readable 11x17 minimum copy floor sketch of the premises to be licensed, including room usage and dimensions (residential and outpatient only).
Once this information is received and approved, the LDH Health Standards Section must conduct an onsite physical environment inspection before final approval can be given for the provider to move into the new location.