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FOR BHF USELL1 2008 STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2008)I.DPH License ID Number: Facility

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1. Ensure you have all the necessary information about the person you are filling out the form for.
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Good Samaritan N in H-Knoxville refers to the non-profit organization that provides assistance to individuals in need in the Knoxville area.

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Individuals or organizations providing assistance through Good Samaritan N in H-Knoxville are required to file the necessary documentation.

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To fill out Good Samaritan N in H-Knoxville forms, individuals or organizations must provide details of the assistance provided and any other required information.

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The purpose of Good Samaritan N in H-Knoxville is to help those in need by providing essential assistance and support.

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Information such as the type of assistance provided, the recipients, and any relevant details must be reported on Good Samaritan N in H-Knoxville forms.