Organization
FUNDAMENTALS FIRST BASKETBALL ACADEMY , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY FLUELLEN SR. (CEO)
(216) 269-1535
Entity
Organization
Contact information
Practice address
977 EDDY RD., CLEVELAND, OH 44108
(216) 269-1535
Mailing address
977 EDDY RD., CLEVELAND, OH 44108
(216) 269-1535
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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