Area Agency on Aging of Northwest Michigan
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Provider Enrollment Forms

AdobeStock 296427484
AdobeStock 40363950

For use by providers.

Completed forms may be emailed to providersupport@aaanm.org or
faxed to (231) 947-6401.

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Provider application
Provider Agreement information sheet
COMPASS Enrollment Form
W-9 form

Phone

(231) 947-8920 or
(800) 442-1713

Fax

(231) 947-6401

Address

Area Agency on Aging of Northwest Michigan
1609 Park Drive
P.O. Box 5946
Traverse City, MI 49696-5946

Email (click here)

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AAANM has proudly served Antrim, Benzie, Charlevoix, Emmet, Grand Traverse, Kalkaska, Leelanau, Manistee, Missaukee, and Wexford counties since 1974.
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