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PRINTED: 07/15/2016 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: (X3) DATE SURVEY COMPLETED R
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Identification number - in is a unique number assigned to individuals or entities for tax identification purposes.
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Identification number - in typically requires information such as name, address, social security number or tax identification number, and other relevant details for tax purposes.
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