Long Term Acute Care (LTAC) Hospitals

Please submit the documentation using the coversheet

Please complete the sheet before faxing to 801-237-0751

Contact Information

General Information

Via U.S. Post Office

Via UPS or FedEx

DHHS, Division of Integrated Healthcare

OHPA/Policy – Attn: LTAC Program Manager

PO Box 143102

Salt Lake City, UT  84114-3102

DHHS, Division of Integrated Healthcare
OHPA/Policy – Attn: LTAC Program Manager
288 North 1460 West
Salt Lake City, UT 84116-3231

If you are unsure about an issue, please ask questions.