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PRINTED: 08/18/2016 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: PREVIEW WHITLEY HOSPITAL (X4)
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An identification number - in is a unique code or number assigned to individuals for the purpose of identification.
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The purpose of an identification number - in is to uniquely identify individuals for various legal and administrative purposes.
The information required to be reported on an identification number - in includes personal details, identification documents, and any other information requested by the authorities.
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2016 Indiana PARKVIEW WHITLEY cjl R57911 LSC Licensure preoccupancy X5 QA IAC X2 X3 X1 CLIA X6 X4 REFERENCED DEFICIENCIES REGULATORY PREFIX continuation CORRECTIVE PRECEDED DEFICIENCY PROVIDER SUMMARY requirements IDENTIFYING SUPPLIER

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