EMResource / DADS Facility Contact Information Please fill out this online form and submit the information so we can send you login credentials and keep you updated on changes in reporting. Please contact us if any questions:903-593-4722support@rac-g.orgThank you. Question Title * 1. Primary Contact Name Question Title * 2. Primary Contact Number Question Title * 3. Primary Title / Position Question Title * 4. Secondary Contact Question Title * 5. Secondary Contact Number Question Title * 6. Secondary Contact Title / Position Question Title * 7. Facility Name Question Title * 8. Facility Type Assisted Living Facility IFC / IID Nursing Home Question Title * 9. NPI (National Provider Number) Question Title * 10. Facility Address Question Title * 11. Website Question Title * 12. Email Done