Functional Living Community Supports

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FUNCTIONAL LIVING COMMUNITY SUPPORTS

Practice address

14221 Reddington Ave
Maple Heights, OH 44137-3209

Phone

(216) 659-1098

NPI assigned

Oct 20, 2020

Last updated

Oct 20, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Saundra J Light Gibbons, OTR/LNPI 1689823320

Title

Ceo

Phone

(216) 367-9017

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Saundra J Light Gibbons, OTR/L

  • Occupational Therapist
  • Maple Heights, OH
  • NPI 1689823320
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1679172738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 GREEN RD UNIT 221048",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227953",
            "telephone_number": "216-367-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14221 REDDINGTON AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441373209",
            "telephone_number": "216-659-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL LIVING COMMUNITY SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "LIGHT GIBBONS",
        "authorized_official_first_name": "SAUNDRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-367-9017",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "funlivcomsup@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "3695 Green Rd Unit 221048",
            "city": "Beachwood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441227953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Octavia French
• Tracy Lee Frith, DPT
• Jasmine Fruits
• Ruth Elizabeth Fuller
• Functional Accessible Living, LLC
• Aurelia Carmen Gamble, RPH
• Dawn Garner
• Marsha Garrison
• Generational Real Estate Investors (Jaystarr Homes 2Inc)
• Geraldj.D'Agostino

• Home Health Agency in Maple Heights, OH
• Providers in Maple Heights, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.