School Age Reimbursement Program: Closed Provider

Please fill out this form if you served school age children on a full-time basis during March 2020 through May 2021 and were only paid the part-time CCPP subsidy for their care. While the name reflects being a "closed" provider, the purpose of this form is to help identify an inactive provider ID that was used during that time period to a currently active CCPP provider ID. If you do not have, a currently active CCPP provider ID, please contact ECCDI by submitting a service ticket at https://mseccdi.com/contact-us/. After reviewing responses to this form, emails will go out to notify of the opening of an application to be completed for the next stage or for an explanation of denial.

The provider ID that belonged to your closed location or used to be the ID of your current location during the eligible time period.

If the facility name has not changed, this name will match the active provider name. If it used to be a different name, please use that name.

The street address belonging to this location. Please include street address, city, state, and zip code.

The current provider ID for your active facility.

This will be the name of your current and active facility.

This does not have to be the street address of your active facility. It should include a street address, city, state, and zip code. If you wish to use a P.O. Box, replace the street address with the P.O. Box that you wish to use.

Please include the Owner's first and last name, email address, and phone number.

Please say yes or no to if you own the business. The location the business is at can be rented or owned.

Please add any additional information that may assist in connecting the closed facility or inactive provider number to the currently active provider ID and facility. This field is not required.