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PRINTED: 05/09/2025 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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Detailed breakdown of each section

Personal information section

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Financial information section

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Ensure financial data is current and accurate
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Additional information section

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040725 refers to a specific form or document that is to be filled out and submitted for a certain purpose, usually related to regulatory or compliance requirements.
Individuals or entities who meet the criteria set forth by the governing body associated with form 040725 are required to file it, which may include businesses, organizations, or individuals in specific professions.
To fill out form 040725, one must carefully read the instructions provided with the form, gather all necessary information, and provide accurate details in the designated fields before submitting it as per the guidelines.
The purpose of form 040725 is typically to collect specific information required by regulatory authorities to ensure compliance with laws and regulations or to gather data for analysis.
Information that must be reported on form 040725 generally includes personal or business identification, financial details, relevant dates, and any other information specified in the form’s instructions.
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