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PRINTED: 01/28/2019 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:MIDWOOD ADDICTION TREATMENT,
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The printed 0128 form, also known as Form 0128, is an official document required for specific regulatory or reporting purposes, often related to financial or tax matters.
Individuals or businesses that meet certain criteria established by government regulations or tax codes are required to file the printed 0128 form.
To fill out the printed 0128 form, one must provide accurate information regarding their identity, financial data, and any other information specified in the instructions accompanying the form.
The purpose of the printed 0128 form is to collect essential information for compliance with legal or regulatory obligations, which may include tax reporting or financial disclosures.
The information that must be reported on the printed 0128 form typically includes personal identification details, income, expenses, and any relevant financial transactions.
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