SSA State/County Code Facility or Service Type Specialty Code Medicare Certification Number (MCN) National Provider Identifier (NPI) Number # of Staffed, MedicareCertified Beds Facility Name Provider Service Street Address Provider Service City Provider Service State Uses CMS MA Provider Service Zip Contract Amendment Code (Y or N)
| File Type | application/pdf |
| File Title | HSD Table Templates |
| Author | CGI Federal |
| File Modified | 2012-09-13 |
| File Created | 2012-09-13 |