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FOR OH FUSE LL1 2000 STATE OF ILLINOIS DEPARTMENT OF PUBLIC AID FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES (FISCAL YEAR 2000) I. DPH Facility ID Number: Facility Name: 0037671
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If applicable, indicate your relationship to the patient or the reason for filling out the form. This could be as a legal guardian, next of kin, or authorized representative.
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Fill in the healthcare provider section, including the name of the healthcare facility, address, and contact details. If there are any specific codes or identification numbers required, ensure they are entered accurately.
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Lasalle healthcare center-0037671 is a healthcare facility located in the Lasalle region.
The owner or operator of Lasalle healthcare center-0037671 is required to file.
The form for Lasalle healthcare center-0037671 can be filled out online or through a paper form.
The purpose of Lasalle healthcare center-0037671 form is to report important healthcare data and information.
Information such as patient statistics, staffing levels, and healthcare services provided must be reported on Lasalle healthcare center-0037671.
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