Organization
FUNCTIONAL LIVING COMMUNITY SUPPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAUNDRA J LIGHT GIBBONS OTR/L (CEO)
(216) 367-9017
Entity
Organization
Contact information
Practice address
14221 REDDINGTON AVE, MAPLE HEIGHTS, OH 44137-3209
(216) 659-1098
Mailing address
3695 GREEN RD UNIT 221048, BEACHWOOD, OH 44122-7953
(216) 367-9017
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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