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PRINTED: 03/05/2013 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: BELL OAKS TERRACE (X4) ID PREFIX
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The identification number - in is a unique number assigned to individuals for identification purposes.
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Information such as name, address, date of birth, and any relevant financial details must be reported on identification number - in.
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