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Certified Provider Details:
| PROVIDER NUMBER: | 490085 |
| AGENCY NAME: | Youth Services System, Inc. |
| CONTACT NAME: | Charles Knight |
| ADDRESS: | 1000 Chapline Street |
| CITY: | Wheeling |
| STATE: | WV |
| ZIP: | 26003 |
| PHONE: | |
| WEB SITE: | www.youthservicessystem.org |
| EMAIL ADDRESS: | cknight@ysswv.com |
| BSW/MSW NAME: | Charles Knight |
| DUE TO RECERTIFY DATE: | 7/1/2010 |
| COMMENTS: |