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PRINTED: 06/03/2021
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 001035?
Facility number 001035 is a unique identifier assigned to a specific facility.
Who is required to file facility number 001035?
The entity or individual responsible for the operation of the facility is required to file facility number 001035.
How to fill out facility number 001035?
Facility number 001035 should be filled out accurately and completely following the guidelines provided by the relevant authority.
What is the purpose of facility number 001035?
The purpose of facility number 001035 is to track and monitor the activities and operations of the designated facility.
What information must be reported on facility number 001035?
Information such as contact details, operational activities, and compliance status must be reported on facility number 001035.
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