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06/29/2022PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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Collect all necessary personal information including name, date of birth, address, phone number, and insurance information.
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Patients seeking personalized and quality medical attention.
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Brickyard Healthcare Portage Care is a healthcare facility located in Portage.
Healthcare providers and facilities who have patients at Brickyard Healthcare Portage Care are required to file.
You can fill out the form online or by submitting a paper form to the appropriate authority.
The purpose of Brickyard Healthcare Portage Care is to ensure that all patients receive necessary care and treatment.
Information such as patient demographics, medical history, and treatment plans must be reported.
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