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You're suggesting an update to Alamitos West Health Care Center, Los Alamitos, CA.
What should each field say? Leave a field blank to leave it as it is. Only the fields you change are sent.

Current: ALAMITOS WEST HEALTH CARE CENTER

Current: 3902 KATELLA AVENUE

Current: LOS ALAMITOS

Current: CA

Current: 90720

Current: 5625965561

Current: (none listed)

Current: (none listed)

Current: (none listed)

Current: (none listed)

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