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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:15525403/19/2012FORM

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F0000 is a form that needs to be filled out during each visit to track important information.

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Anyone visiting the location is required to fill out the f0000 form.

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