Join Our Network

Community Care offers member-centered care to seniors and adults with intellectual and physical disabilities in eastern Wisconsin. We are the only Wisconsin organization to offer all three long-term care programs: Family Care, Partnership and the Program of All-Inclusive Care for the Elderly (PACE).

We are always looking to add providers to our network who share Community Care’s mission to deliver quality, cost-effective care to the members we serve. We review our network needs before proceeding with applications. If we determine that there is not a current need for the service(s) you offer, we will notify you and keep your application on file.

Community Care requires that all providers have a Medicaid number when submitting an application for consideration. Effective January 1, 2026, all providers must have a Medicaid number for each service/location where they provide services. If you do not have a Medicaid number for each of the services you provide prior to January 1, 2026, you cannot provide services or receive payment from managed care organizations (MCO’s) or IRIS (Include, Respect, I Self-Direct).

Information regarding the Provider Enrollment System for Adult Long Term Care can be found here:

If you have questions or need confirmation as to which application you should complete, call 1-866-937-2783 and select option 2.

Download an application below to get started:

General Application: Word, PDF
Owner-Occupied Adult Family Home (OOAFH) Application: Word, PDF
Transportation Provider Application: Word, PDF
Health Care Group Application: Word, PDF

Application Forms

• Attestation Form (Word or PDF format) to be completed by all providers
• W-9 Form (to be completed by all providers)
• Residential Summary (Word or PDF format) to be completed by all residential providers

Note: Community Care will not accept photos or screenshots of any application materials.

Submit completed application materials to:

EMAIL: contractinquiries@communitycareinc.org

or FAX: (262) 446-6707