Healthcare Provider Details

I. General information

NPI: 1164339644
Provider Name (Legal Business Name): TWIN RIVERS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6190 STATE ROUTE 365
STURGIS KY
42459-5357
US

IV. Provider business mailing address

21263 DOUBTFUL CANYON DR
CYPRESS TX
77433-8470
US

V. Phone/Fax

Practice location:
  • Phone: 949-359-5669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW LEE
Title or Position: ADMIN
Credential:
Phone: 949-359-5669