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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:15G34308/18/2015FORM
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Complaint in00175284 refers to a formal grievance or issue reported regarding a specific situation or violation.
Any individual or entity that has been directly affected by the situation or has relevant information regarding the issue is required to file the complaint.
To fill out the complaint, provide all necessary details in the required format, including the complainant's information, a detailed description of the issue, and any supporting documentation.
The purpose of the complaint is to formally bring attention to a violation or misconduct and seek resolution or corrective action.
The complaint must report specific details such as the complainant's contact information, a clear statement of the issue, dates and locations of the incident, and any witnesses or evidence.
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