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PRINTED 12/14/2012 FORM APPROVED State of GA Healthcare Facility Reoulation Division STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION X1 PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER X2 MULTIPLE CONSTRUCTION X3 DATE SURVEY COMPLETED A BUILDING B. WING 044-493-D NAME OF PROVIDER OR SUPPLIER NARCONON OF GEORGIA X4 ID PREFIX TAG 11/13/2012 STREET ADDRESS CITY STATE ZIP CODE 5688 PEACHTREE PARKWAY B1 NORCROSS GA 30092 SUMMARY STATEMENT OF DEFICIENCIES EACH DEFICIENCY MUST BE PRECEDED BY FULL...
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The reoulation form is a document that is used to report certain information to the relevant authorities.
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The individuals or organizations that meet the specified criteria set by the authorities are required to file the reoulation form.
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