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PRINTED: 04/04/2024
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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920 W Highway 46 is the physical address of a property or business location.
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The owner or operator of the property or business located at 920 W Highway 46 is required to file this information.
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To fill out 920 W Highway 46, you need to provide details about the property or business, including the name of the owner, contact information, and any other relevant information.
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The information that must be reported on 920 W Highway 46 includes the name of the owner, contact information, business type, and any other pertinent details.
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