Healthcare Provider Details
I. General information
NPI: 1902737752
Provider Name (Legal Business Name): KYALAMI HOUSING AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1617 N CAHUENGA BLVD
LOS ANGELES CA
90028-6201
US
IV. Provider business mailing address
1439 N HIGHLAND AVE # 308
LOS ANGELES CA
90028-7622
US
V. Phone/Fax
- Phone: 424-281-7828
- Fax:
- Phone: 424-281-7828
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VARIETY
CHENEVERT
Title or Position: FOUNDER/CEO
Credential:
Phone: 424-281-7828