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PRINTED: 01/29/2008 FORM APPROVED DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION

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How to fill out 524 east 800 north

How to Fill out 524 East 800 North:

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Start by writing the street number "524" in the designated field.

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Next, write the direction "East" followed by a space.

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Then, write the street name "800 North" in the appropriate field.

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524 east 800 north refers to a specific address located at the intersection of East 800 North and East 524th Street.

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