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PRINTED: 12/15/2020 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Printed 1215 refers to a specific tax form or document managed by the Department of Revenue or a similar governmental agency, used for reporting certain financial information.
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Individuals or entities specified by the Department of Revenue, typically those who meet certain financial thresholds or engage in specific types of business activities, are required to file the printed 1215 form.
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