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PRINTED: 10/23/2020
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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What is facility number 012619?
Facility number 012619 refers to a specific identification number assigned to a facility for regulatory or reporting purposes.
Who is required to file facility number 012619?
Entities operating or managing the facility identified by number 012619 are required to file associated reports.
How to fill out facility number 012619?
To fill out facility number 012619, follow the provided guidelines including entering the facility's details, compliance information, and any required data specific to operations.
What is the purpose of facility number 012619?
The purpose of facility number 012619 is to track and manage compliance and regulatory obligations associated with the facility in question.
What information must be reported on facility number 012619?
The information that must be reported includes facility operational data, compliance records, and any incidents or changes in status relevant to regulatory bodies.
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