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APPENDIX B MISSISSIPPI STATE DEPARTMENT OF HEALTHNOTICE OF INTENT TO CHANGE OWNERSHIP (Must be accompanied by $250 processing fee)Part I: Facility InformationFacility Name:Address:City:State:Zip Code:County:Telephone:Number/Type
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Part iFacility information is a section of a form that includes details about the facility where certain activities are taking place.
The individuals or entities conducting the activities specified on the form are required to file part iFacility information.
Part iFacility information can be filled out by providing accurate details about the facility where the activities are happening, following the instructions on the form.
The purpose of part iFacility information is to ensure that the authorities have a clear understanding of the locations where certain activities are being carried out.
Part iFacility information typically includes details such as the address of the facility, contact information, and any relevant permits or certifications.
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