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PRINTED 06/08/2017 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. Complaint IN00230552 - Substantiated. No deficiencies related to the allegations are cited. Survey date 06/06/17 Facility number 010757 Residential Census 68 Brookdale Valparaiso was found to be in compliance with 410 IAC 16. BUILDING X3 DATE SURVEY COMPLETED B. WING 010757 NAME OF PROVIDER...
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