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PRINTED: 08/06/2021 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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Facility number 000306 is a unique identifier assigned to a specific facility.
The entity or individual responsible for the operation of the facility is required to file facility number 000306.
To fill out facility number 000306, you must provide all required information accurately and completely as per the guidelines provided.
The purpose of facility number 000306 is to track and monitor activities and compliance of the specific facility.
Information such as facility location, activities, ownership, and any relevant permits or certifications must be reported on facility number 000306.
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