Administrator Information

The Recovery Residence Administrator role is responsible for accurately completing the application and for ensuring that the recovery residence upholds the standard overtime.

Administrator Name(Required)

First Last

Administrator Email(Required)

Administrator Phone(Required)

Recovery Residence Administrator Certificate

Some states offer a Administrator training. If you have completed a Recovery Residence Administrator training, upload the Certificate of Completion. Otherwise, skip this question. [Note: the file format must be in one of the following: jpg, gif, png, or pdf]

Accepted file types: jpg, gif, png, pdf, Max. file size: 16 MB.

Recovery Residence Experience(Required)

Describe your experience owning, operating, supervising or staffing a recovery residence.

Criminal History(Required)

List criminal convictions within the last 10 years. If none, enter "none". Note: Some states may restrict the ability for someone to serve in the Administrator Role, if they have had particular criminal convictions in the past. Before submitting this application, check with your state agency and/or NARR state affiliate to verify the current regulation and your eligibility status.

Administrator Certification Suspension History(Required)

Has the certification of a recovery residence owned, operated or managed by you (the Administrator) ever been revoked or suspended?

Yes.

No.

Organization Information

Organization Legal Name(Required)

Organization Start Date(Required)

When was the organization founded? (MM-DD-YYYY)

Entity Type(Required)

What type of entity is this organization / recovery residence provider?

Sole proprietorship

Unincorporated non-profit

Incorporated non-profit (e.g. 501c3 or 501c6)

Incorporated for profit (e.g. C Corp, S Corp, LLC)

Other

EIN(Required)

Federal Employer Identification Number. ##-#######

Incorporation Documents(Required)

Upload your incorporation documents. [Note: the file format must be in one of the following: jpg, gif, png, or pdf]

Accepted file types: jpg, gif, png, pdf, Max. file size: 16 MB.

Certificate-of-Incorporation-4.pdf

DBAs

List any relevant aliases or doing business as (DBA)

DBA Documents

If you operate under a Doing Business As (dba), upload the registration documents. [Note: the file format must be in one of the following: jpg, gif, png, or pdf]

Accepted file types: jpg, gif, png, pdf, Max. file size: 16 MB.

Treatment Provider License Number(Required)

If this organization is a state licensed treatment provider, enter the license number. Otherwise enter "Not licensed"

Organization Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Organization Phone Number(Required)

Org Chart(Required)

Upload your Organizational Chart, which is a diagram that shows the structure of an organization and the relationships and relative ranks of its parts and positions/jobs. [Note: the file format must be in one of the following: jpg, gif, png, or pdf]

Accepted file types: jpg, gif, png, pdf, Max. file size: 16 MB.

z2023-DCL-Manual-rev4.docx

Organization Certification Suspension History(Required)

Has the certification of this organization's recovery residence(s) ever been revoked or suspended by an Affiliate of the National Alliance for Recovery Residences in this or any other state?

Yes

Certification Outline

Not Enrolled

Recovery Residence Certification

	1. Orientation
	1.1. Certification Process
	1.2. User Agreement
	1.3. Frequently Asked Questions
	1.4. Levels of Support
	1.5. NARR Standards
	2. Provider Information
	2.1. Administrator Information
	2.2. Eligibility Self Screening
	3. Policies, Documents and Attestations
	3.1. Policies and Procedures
	3.2. Liability Insurance
	3.3. Landlord Agreement(s)
	3.4. Compliance
	3.5. Marketing
	3.6. Conflicts of Interest
	3.7. Resident Agreements
	3.8. Staff and Leaders
	4. Programs and Properties
	4.1. Programs (Service Models)
	4.2. Properties