Arizona Behavioral Health & Substance Use Licensing Guide

Licensing agency

Arizona Department of Health Services (ADHS)Behavioral health facilities and medical facilities licensing

Rules

9 A.A.C. 10Statute: A.R.S. Title 36, Chapter 4

Applications

Online Licensing Management SystemPaper forms are no longer accepted

Sober living

Licensed by ADHSA.R.S. 36-2061 and 9 A.A.C. 12

Accreditation

Can replace compliance inspections, not the initial oneA.R.S. 36-424, at ADHS’s discretion

Who licenses behavioral health programs in Arizona?

ADHS licenses them as health care institutions. Its Bureau of Behavioral Health Facilities Licensing covers behavioral health residential facilities (BHRFs, secure and non-secure), adult residential care institutions, adult behavioral health therapeutic homes, behavioral health respite homes, counseling facilities and sober living homes.¹

Initial applications for behavioral health inpatient facilities, outpatient treatment centers and substance abuse transitional facilities are listed under ADHS’s medical facilities licensing.²

Medicaid is run by AHCCCS, which enrolls providers separately and requires BHRFs to hold an ADHS license.^{11, 12}

License types

• Behavioral health residential facility (BHRF): residential treatment. A secure BHRF serves only people placed by court order and is capped at 16 beds.¹
• Outpatient treatment center (OTC): licensed for behavioral health, it can add services such as opioid treatment, crisis services, court-ordered treatment and observation or stabilization. OTCs cannot provide overnight or inpatient stays.³
• Counseling facility: a separate, narrower class; ADHS publishes a handout comparing it with an OTC.³
• Behavioral health inpatient facility and substance abuse transitional facility, under their own articles of 9 A.A.C. 10.^{2, 4}
• Sober living home: a home that advertises a recovery environment. Premises licensed for on-site behavioral health or medical services are excluded.⁵

Which class covers withdrawal management depends on your setting and services, so confirm it with ADHS before you choose a site.

Law and rules

Behavioral health facilities are licensed under A.R.S. Title 36, Chapter 4 and 9 A.A.C. 10, which includes Article 1 (general), Article 7 (BHRFs and adult residential care institutions), Article 16 (respite homes), Article 18 (therapeutic homes) and Article 19 (counseling facilities).¹ ADHS’s rule-review list places inpatient facilities in Article 3, outpatient treatment centers in Article 10 and substance abuse transitional facilities in Article 14.⁴ Sober living homes fall under A.R.S. 36-2061 et seq. and 9 A.A.C. 12.¹

How to apply

1. Apply 60 to 120 days before openingStatute sets that window for initial applications.⁶
2. File in the Licensing Management SystemAll applications and renewals go through ADHS’s online system; paper forms are no longer accepted.¹
3. Attach the site documentsFor medical-facility classes: a floor plan, site plan, certificate of occupancy, a fully executed lease with exclusive rights, current articles of incorporation and the fee.²
4. Answer the deficiency noticeADHS reviews the application and sends a notice and request for information if anything is missing.⁷
5. Pass the initial surveySurveyors review policies and procedures and personnel records, tour the facility (including measurements and water temperatures) and interview staff. The license issues after a deficiency-free statement of deficiencies and payment of fees.⁷

ADHS must approve or deny a complete initial application within 90 days.⁸ Most outpatient treatment centers can request a temporary license on attestation, issued within seven days.⁶

Change of ownership: give ADHS 30 days’ notice. The new owner cannot operate until ADHS issues it a license, and ADHS can deny the change based on the new owners’ licensing history.^{6, 9} Sober living licenses last one year, are valid only for the licensed premises and cannot be transferred.¹⁰

Licensing fees

Every health care institution application also carries a $50 nonrefundable application fee.^{1, 13, 14} ADHS’s behavioral health remittance form says payment is accepted only through the online system, while the medical facilities form still lists checks, so confirm how to pay.

How accreditation counts in Arizona

Accreditation is not required for an ADHS license, but it can reduce inspections. Under A.R.S. 36-424, ADHS may accept an accreditation report in place of its compliance inspections, if the accreditor is a nonprofit approved by the U.S. Department of Health and Human Services, the report covers the licensed premises and the facility had no enforcement action in the prior year.¹⁵ The initial licensing inspection is still required.⁸

ADHS’s pages do not name which accreditors it accepts, so confirm whether a CARF or Joint Commission report will count for your facility class.

Opioid treatment: federal certification requires accreditation from an approved body such as CARF or The Joint Commission, plus SAMHSA certification and DEA registration.¹⁶

Other approvals you may need

• AHCCCS enrollment through APEP, revalidated every four years. Since May 29, 2023, BHRFs, integrated clinics and behavioral health outpatient clinics are high-risk provider types, which adds an application fee, fingerprinting and a site visit.^{11, 17}
• Fingerprinting delays: AHCCCS warns that DPS digital fingerprinting is unavailable from October 30, 2026, which may slow applications.¹¹
• Local approvals: a certificate of occupancy, and fire code review by the State Fire Marshal or a delegated city.¹⁸
• Opioid treatment programs: SAMHSA certification and DEA registration alongside the state license.¹⁶

Recent changes

• The fraud response: after widespread fraud involving sober living homes and behavioral health providers, AHCCCS suspended payments to hundreds of providers and put a moratorium on new BHRF and outpatient clinic enrollments. Its most recent published notice ran from June 9 to December 9, 2024; confirm the current status.^{19, 20}
• SB 1308 (effective September 26, 2025): inspections before licensure instead of self-attestation, annual inspections, fines of up to $1,000 per violation per resident per day, fingerprint cards and new patient-brokering felonies.²¹
• SB 1219 (effective September 26, 2025): behavioral health outpatient treatment centers must record a patient’s sober living home at intake, and ADHS must publish a complaint priority matrix.²²
• SB 1630 (2026): creates a new licensed class, the enhanced residential treatment facility for people with serious mental illness, with ADHS rules to follow.²³
• Pending ADHS rulemakings on sober living homes, transitional housing, counseling facilities (Article 19) and therapeutic homes (Article 18).²⁴

Confirm these with ADHS or AHCCCS

• Which license class covers your withdrawal management or opioid treatment services.
• Whether ADHS will accept your CARF or Joint Commission report in place of compliance inspections.
• Whether a change of ownership triggers a new inspection.
• Whether the AHCCCS enrollment moratorium affects your provider type.
• Current fees and how to pay, and the final text and dates of the pending sober living rules.

Sources

1. Arizona ADHS, Bureau of Behavioral Health Facilities Licensing. azdhs.gov
2. Arizona ADHS, Medical facilities licensing: initial applications. azdhs.gov
3. Arizona ADHS, Counseling facility vs. outpatient treatment center handout. azdhs.gov
4. Arizona ADHS, Rules: five-year-review reports. azdhs.gov
5. Arizona Revised Statutes 36-2061, Definitions (sober living homes). azleg.gov
6. Arizona Revised Statutes 36-422, Application for license. azleg.gov
7. Arizona ADHS, Licensing process and initial survey. azdhs.gov
8. Arizona Revised Statutes 36-425, Inspections; issuance of license. azleg.gov
9. Arizona Revised Statutes 36-420.05. azleg.gov
10. Arizona Revised Statutes 36-2062. azleg.gov
11. AHCCCS, Provider enrollment applications and revalidations. azahcccs.gov
12. AHCCCS Medical Policy Manual, Policy 320-V. azahcccs.gov
13. Arizona ADHS, Behavioral health facilities application and license fee remittance form. azdhs.gov
14. Arizona ADHS, Medical facilities remittance form. azdhs.gov
15. Arizona Revised Statutes 36-424, Inspections. azleg.gov
16. 42 CFR 8.11, Opioid treatment program certification (eCFR). ecfr.gov
17. AHCCCS, High-risk provider screening (press release). azahcccs.gov
18. Arizona ADHS, Certificate of occupancy vs. fire marshal inspection. azdhs.gov
19. AHCCCS, Behavioral health provider moratorium notice. azahcccs.gov
20. AHCCCS, Sober living fraud response. azahcccs.gov
21. Arizona Laws 2025, Chapter 66 (SB 1308). azleg.gov
22. Arizona Laws 2025, Chapter 64 (SB 1219). azleg.gov
23. Arizona Laws 2026, Chapter 237 (SB 1630). azleg.gov
24. Arizona ADHS, Active rulemakings. azdhs.gov

This guide summarizes Arizona statutes, rules and ADHS and AHCCCS pages as of the date above. It is general information, not legal advice. Requirements change; confirm with ADHS and AHCCCS before you apply.