Nevada Early Intervention Services Provider Service Agreements

Thank you for your interest in partnering with Nevada Early Intervention Services to deliver much needed services to our community.

To get started with our process, please complete, sign and date the:

Provider Service Agreement Application
Provider Survey
and the applicable Scope of Work for the service you wish to provide

In addition, please review the current Reimbursement Rates sheet for applicable services, so that you clearly understand the currently approved rates for services prior to applying to be a provider.

Please mail your application, survey, and scope of work to the address below, and as indicated on the last page of the application.

Provider Service Agreements - Nevada Early Intervention Services
Aging and Disability Services Division
3416 Goni Road, Bldg. D #132
Carson City, NV 89706

NOTE: This application process does not guarantee approval to be a provider of services. A complete, accurate and thorough application and survey is critical to the internal NEIS review of your eligibility to be approved as a provider of services.

Once your completed application packet is received, it will be reviewed internally by NEIS staff, and you will be contacted as to whether the application is approved to move into the formal Provider Agreement process.