Administrator Information

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)
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.
Describe your experience owning, operating, supervising or staffing a recovery residence.
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Has the certification of a recovery residence owned, operated or managed by you (the Administrator) ever been revoked or suspended?

Organization Information

When was the organization founded? (MM-DD-YYYY)
MM slash DD slash YYYY
Entity Type(Required)
What type of entity is this organization / recovery residence provider?

Federal Employer Identification Number. ##-#######
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.
Cert-of-Incorp.pdf
List any relevant aliases or doing business as (DBA)
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.
If this organization is a state licensed treatment provider, enter the license number. Otherwise enter "Not licensed"
Organization Mailing Address(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.
19305.jpg
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?