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FOR OH FUSE LL1 2004 STATE OF ILLINOIS DEPARTMENT OF PUBLIC AID FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES (FISCAL YEAR 2004) I. DPH Facility ID Number: Facility Name: 0032946
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Litchfield Terrace - HFS is a form used by the Illinois Department of Healthcare and Family Services.
Providers who receive payments from the Illinois Department of Healthcare and Family Services are required to file Litchfield Terrace - HFS.
Litchfield Terrace - HFS can be filled out electronically on the HFS website or by mailing a paper copy to the department.
The purpose of Litchfield Terrace - HFS is to report information about healthcare services provided and payments received.
Information such as provider information, services provided, dates of service, and payment details must be reported on Litchfield Terrace - HFS.
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