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PRINTED: 07/05/2023 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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0705 form approved is a tax form used for reporting certain types of income and deductions to the IRS.

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Individuals or entities that have specific types of income or deductions as outlined by the IRS are required to file 0705 form approved.

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