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PRINTED: 01/21/2020 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION A.

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Melody House1 LLC is a limited liability company that specializes in selling musical instruments and equipment.

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The owners or members of Melody House1 LLC are required to file the necessary documents with the state government.

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To fill out Melody House1 LLC, the owners or members need to provide information such as business address, member names, business purpose, and financial details.

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The purpose of Melody House1 LLC is to operate as a retail business selling musical instruments and equipment.

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Information such as business address, member names, business purpose, and financial details must be reported on Melody House1 LLC.

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