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PRINTED: 09/01/2017 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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Printed 0929 is a specific form used by certain departments for reporting purposes, typically associated with tax or regulatory compliance.
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The information required typically includes identification details, financial data, and any other specifics outlined by the department associated with the form.
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