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PRINTED: 06/30/2017
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 building 01 - 2140?
Building 01 - 2140 is a commercial property located in downtown area.
Who is required to file building 01 - 2140?
The owner or operator of building 01 - 2140 is required to file the necessary paperwork.
How to fill out building 01 - 2140?
Building 01 - 2140 can be filled out by providing accurate information about the property including address, size, and intended use.
What is the purpose of building 01 - 2140?
The purpose of building 01 - 2140 is to serve as a retail space for businesses.
What information must be reported on building 01 - 2140?
Information such as ownership details, property specifications, and compliance with building codes must be reported on building 01 - 2140.
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