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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:15527710/31/2016FORM

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Complaint in00209604 is a formal statement of grievance or dissatisfaction made by a person regarding a specific issue or situation.

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To fill out complaint in00209604, one must provide details of the issue, relevant facts, supporting documentation, and contact information.

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The purpose of complaint in00209604 is to bring attention to a problem or concern, seek resolution, and possibly initiate a formal investigation.

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Information such as date of incident, names of individuals involved, description of issue, and desired outcome must be reported on complaint in00209604.

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