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Intermediate Care Facilities for the Mentally Retarded
Duplicate License
The form may be completed on-line, however, it cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form on-line, you must print the form and mail it to the address below.
A duplicate or reissued license is available for a fee of $10.00.  Duplicate/Reissue Form
Licensure Unit
ICF/MR
PO Box 94986
Lincoln, NE 68508-9486
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