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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15533104/23/2014FORM
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Survey date 040814 refers to the specific date of August 14, 2004.
All individuals or entities who are requested to do so by the relevant authority.
Survey date 040814 must be filled out with accurate and up-to-date information as requested by the survey form.
The purpose of survey date 040814 is to gather specific data or information for analysis or regulatory compliance.
The specific information required to be reported on survey date 040814 will be detailed in the survey form or instructions.
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