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Community Health Center 2 West Main Street Johnstown NY 12095 Call 518-762-8215 x1072 Home Care/Care Transitions Intervention Preventable Readmissions DSRIP Fax Referral to 518-762-7527 Fast Start Care Transitions Intervention Attach discharge summary/Office Summary for Medications/Allergies Patient Name DOB Home address Telephone H Cell Work Patient email Primary Language List Medical/Behavioral Health Diagnosis P Insurance Plan ID S Insurance Plan ID Primary Care Provider Office Fax...
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