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01/22/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION

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How to fill out dates of survey 121117

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Start by entering the survey number '121117' at the top of the form.

02

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Dates of Survey 121117 refers to a specific survey that collects data on certain demographic or economic factors relevant to regulatory or auditing purposes.

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The survey requires reporting information such as demographic details, economic activities, and any other data specified in the filing guidelines.

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