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PRINTED 01/09/2017 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION X1 PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER BROOKDALE VALPARAISO X4 ID PREFIX TAG A. This visit included the Investigation of Complaint IN00216073. deficiencies related to the allegations are cited. Survey date January 8 2017 Facility number 010757 Provider number 010757 Residential Census 79 Sample 5 Brookdale Valparaiso was found to be in compliance with 410 IAC 16....
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