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PRINTED: 06/16/2017 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION

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What is 201 e elm st?

Located at 201 E Elm St, this address is a commercial building in a downtown area.

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The purpose of 201 E Elm St form is to report information about the commercial building located at that address.

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Information such as property details, ownership information, and any changes to the building must be reported on the form for 201 E Elm St.

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