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PRINTED: 04/20/2017 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 this building is type?

This building is type is commercial.

Who is required to file this building is type?

Owners and managers of commercial properties are required to file this building is type.

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The building is type form can be filled out online or submitted in person to the appropriate government agency.

What is the purpose of this building is type?

The purpose of this building is type is to provide information about the usage and ownership of commercial properties.

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Information such as property address, owner's contact information, and usage of the property must be reported on this building is type.

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