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NPI Code Detail

MEDICARE: KOALEH LLC.

MEDICARE: KOALEH 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
1174200000XMeals Provider
2251E00000XHome Health Agency
3253Z00000XIn Home Supportive Care Agency
4261QA0600XAdult Day Care Clinic/Center
5276400000XSubstance Use Disorder Rehabilitation Hospital Unit
6311Z00000XCustodial Care Facility
7311ZA0620XAdult Care Home Facility
8343900000XNon-emergency Medical Transport (VAN)
9347C00000XPrivate Vehicle
10347E00000XTransportation Broker
11177F00000XLodging Provider

General Provider Information

NPI Number : 1962335190
Entity Type Code : Organization
Provider Name (Legal Business Name) : KOALEH LLC.
Provider Business Mailing Address
First Line : 1942 W GRAY ST # 474
Second Line :
City : HOUSTON
State : TX
Zip : 77019-4816
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7803 JESTER ST UNIT AB
Second Line :
City : HOUSTON
State : TX
Zip : 77051-1633
Country : US
Telephone Number : 312-953-5274
Fax Number :
Authorized Official
Title or Position : PROGRAM OPERATOR
Name : LEKARI DAVIS-HARRIS
Credential :
Telephone Number : 312-953-5274
Provider Enumeration Date : 06/06/2026
Last Update Date : 06/06/2026

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Directions to “KOALEH LLC. ” Practice Location

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