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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:15532806/02/2016FORM

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Anyone who has encountered an issue, problem, or grievance related to the organization's services, products, or conduct may need to file a complaint with the organization using the complaint in00196004. This could include customers, clients, employees, or other stakeholders who want to formally address their concerns, seek resolution, or bring attention to the matter.

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The complaint in00196004 is a formal written document outlining a grievance or concern.

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The individual or entity affected by the issue outlined in complaint in00196004 is required to file the complaint.

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To fill out complaint in00196004, the individual must provide detailed information about the issue, including dates, names, and any supporting evidence.

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The complaint must include details such as the nature of the issue, parties involved, dates, locations, and any supporting documentation.

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