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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:15539006/12/2013FORM
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Complaint in00128779 is a formal statement alleging misconduct or violation of rules.
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The individual or entity who has information or evidence regarding the alleged misconduct is required to file complaint in00128779.
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Complaint in00128779 can be filled out by providing detailed information about the alleged misconduct, including evidence and relevant dates.
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The purpose of complaint in00128779 is to address and investigate the alleged misconduct or violation of rules.
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Information such as details of the misconduct, evidence, dates, and names of individuals involved must be reported on complaint in00128779.
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