OLTL Community HealthChoices – Direct Service Provider Completion

Congratulations on completing the OLTL Community HealthChoices – Direct Service Provider online training. To register your completion of the training, please complete the fields below.

(Your provider number and service location are used to log into the PROMISe™ portal. Your provider number and service location can also be found on your OLTL provider approval notice for enrollment in waivers.)

Your Name*
First Last
Job Title*
Organization Name*
Is Your Organization a:*
- Service Coordination Entity
- Direct Service Provider enrolled with OLTL
- Managed Care Organization
Provider Number (9 Characters)*
Service Location (4 Characters)*
Email*