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Certified Provider Details:
| PROVIDER NUMBER: | 490060 |
| AGENCY NAME: | FMRS Mental Health Council, Inc. |
| CONTACT NAME: | Elizabeth Vandall |
| ADDRESS: | 101 S. Eisenhower Drive |
| CITY: | Beckley |
| STATE: | WV |
| ZIP: | 25801 |
| PHONE: | |
| WEB SITE: | www.fmrs.org |
| EMAIL ADDRESS: | evandall@fmrs.org |
| BSW/MSW NAME: | Jennifer Hamrick |
| DUE TO RECERTIFY DATE: | 7/1/2012 |
| COMMENTS: |