Organization
KOU BEHAVORIAL HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WORTEE YALLAY (CEO)
(609) 222-0263
Entity
Organization
Contact information
Practice address
19752 W BUCHANAN ST, BUCKEYE, AZ 85326-3054
(480) 203-2718
Mailing address
19752 W BUCHANAN ST, BUCKEYE, AZ 85326-3054
(480) 203-2718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
04/16/2025
Last updated
05/05/2026
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