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PRINTED: 04/12/2019 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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Printed 0214 - form is a tax form used for reporting income and expenses related to certain activities.
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Printed 0214 - form requires reporting of income, expenses, and other relevant financial information related to the specified activities.
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