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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES MEDICARE/MEDICAID CERTIFICATION AND TRANSMITTAL ID: CGZ PART I TO BE COMPLETED BY THE STATE SURVEY AGENCY 245461 (L1)
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Start by entering your personal details such as your full name, contact information, and address.
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Indicate the number of employees under your supervision and outline their roles and tasks.
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