Guided intake wizard

Eight steps, one screen at a time. Fields appear only when they apply to your answers. Nothing is guessed — anything unknown becomes an open item.

Overall completion 0%

Step 1 of 8 — Identity & transaction

0% complete

Service requestedrequired

Pick the enrollment pathway

Legal entity name (IRS)required

As on IRS CP-575

EINrequired

Demo format 00-DEMO###

Facility / DBA namerequired

Name on signage

Entity typerequired

Sets ownership capture rules

Formation staterequired

Not known

Formation daterequired

Not known

Organization NPIrequired

Demo format 80-DEMO-####

CCNrequiredshown because: service!=initial

Existing enrollments only

Not known

PTANrequiredshown because: service!=initial

Never guessed

Not known

Primary contactrequired

Name, email, phone

0 not known · 0 help requested