MEDICARE: WILLIAM & ANNIE LUE RESIDENTIAL SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639769367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM & ANNIE LUE RESIDENTIAL SERVICES LLC

Provider Business Mailing Address
First Line	:	6687 BASSWOOD DRIVE
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146
Country	:	US
Telephone Number	:	216-376-9961
Fax Number	:

Provider Business Practice Location Address
First Line	:	6687 BASSWOOD DR
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-4810
Country	:	US
Telephone Number	:	216-376-9961
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO/BSW/LSW
Name	:	MRS. VERONICA GAIL SWEENEY
Credential	:
Telephone Number	:	216-376-9961

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	08/04/2025

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