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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:15568701/05/2015FORM
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Complaint in00159662 is a formal statement alleging misconduct or issues regarding a specific matter.
The individual or entity affected or involved in the misconduct or issue is required to file complaint in00159662.
The complaint form must be completed with detailed information about the incident, parties involved, and any evidence or supporting documentation.
The purpose of complaint in00159662 is to formally document and address the misconduct or issues raised by the individual or entity.
The complaint must include details such as date, time, location of incident, names of individuals involved, description of the issue, and any supporting evidence.
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