Contact for Change location for a temporary nursing service agency
Division of Health Care Facility Licensure and Certification
The Details of Change location for a temporary nursing service agency
What you need for Change location for a temporary nursing service agency
You will need to provide the following information in the Application for Change of Location
- Agency Registration Number
- Agency Name
- Office address prior to move
- Office address after move
- New telephone and fax numbers
- Start date for the new address
Fees for Change location for a temporary nursing service agency
Please submit one check for all location changes, and make it payable to "Commonwealth of Massachusetts."
| Name | Fee | Unit |
|---|---|---|
| Change of location | $100 | for each location change |
How to change Change location for a temporary nursing service agency
- Download and complete the Application for Change of Location (DOCX)
- Mail completed application and check for fee payment(s) to:
Licensure Coordinator
Department of Public Health, Division of Health Care Facility Licensure and Certification
67 Forest Street
Marlborough, MA 01752
Downloads for Change location for a temporary nursing service agency
Open DOCX file, 31.84 KB, for
Application for Change of Location
(DOCX 31.84 KB)
Contact for Change location for a temporary nursing service agency
Address
67 Forest St., Marlborough, MA 01752