Become a 3rd Party Provider

BECOME A THIRD PARTY PROVIDER (3PP)

Consent(Required)

Company Information

Address

Contact Information

Name

Alternate Contact

Name

Availability

Areas of Louisiana you are willing to serve (mark all that apply):(Required)

Organization Profile

Please mark your top four services which best describe the particular area(s) of your organization's expertise:

Organizational Profile

Thank You!

Once you submit your Third Party Registration, a member of the LCTCS MEP of LA team will contact you with next steps in the registration process. We look forward to including you in our third party provider network!