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PRINTED: 04/06/2018
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 - building?
Building 01 - building is a government form used to report information about a specific building.
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Information such as building address, number of floors, usage type, occupancy details, and contact information must be reported on building 01 - building.
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