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Certified Provider Details:
| PROVIDER NUMBER: | 490101 |
| AGENCY NAME: | Seneca Health Services, Inc |
| CONTACT NAME: | Amy LeRose |
| ADDRESS: | 1305 Webster Road |
| CITY: | Summersville |
| STATE: | WV |
| ZIP: | 26651 |
| PHONE: | (304) 872-6503 |
| WEB SITE: | www.shsinc.org |
| EMAIL ADDRESS: | info@shsinc.org |
| BSW/MSW NAME: | Karen O. Dotson |
| DUE TO RECERTIFY DATE: | 7/1/2012 |
| COMMENTS: |