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1. Name of facility: Address: City: State: Zip: 2. Name of insurance company that provides professional liability insurance: 3. Is the facility licensed and/or accredited by any agency? Telephone:
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Start by identifying the specific name of the facility you are referring to. This could be the name of a building, organization, or any other relevant entity.
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Who needs 1 name of facility:
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Individuals responsible for completing official forms or documents that require identifying information about a specific facility. This could include employees, students, or any individuals affiliated with the facility in question.
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