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FOR BHF USELL1
2019STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2019)I.DPH License ID Number:
Facility
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612 West St is a form that is typically associated with tax reporting, often required by a specific government agency for various purposes.
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