MEDICARE: KYALAMI HOUSING AGENCY INC

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	251B00000X	Case Management Agency
2	385H00000X	Respite Care

General Provider Information

NPI Number	:	1902737752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYALAMI HOUSING AGENCY INC

Provider Business Mailing Address
First Line	:	1439 N HIGHLAND AVE # 308
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7622
Country	:	US
Telephone Number	:	424-281-7828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 N CAHUENGA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6201
Country	:	US
Telephone Number	:	424-281-7828
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	VARIETY CHENEVERT
Credential	:
Telephone Number	:	424-281-7828

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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