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PRINTED: 03/10/2021 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:WILSHIRE FORT HARRISON (X4) ID
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Facility number 014109 refers to a specific identifier given to a particular facility for tracking and reporting purposes.
The entity or individual responsible for the operation of facility number 014109 is required to file and report information related to that facility.
Facility number 014109 should be filled out by providing accurate and detailed information about the operations, activities, and any other relevant data pertaining to that specific facility.
The purpose of facility number 014109 is to monitor, regulate, and ensure compliance with relevant laws and regulations for the operation of that particular facility.
The information that must be reported on facility number 014109 includes but is not limited to operational activities, environmental impact, compliance with regulations, and any other data required for monitoring and reporting purposes.
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