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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:15565902/25/2014FORM

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Complaint in00142554 is a formal statement expressing dissatisfaction or grievance.

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To fill out complaint in00142554, provide detailed information about the issue, including dates, names, and any supporting documentation.

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Information such as names of parties involved, description of issue, dates, and any supporting evidence must be reported on complaint in00142554.

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