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General NPI Number Information
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NPI Number | 1861828600
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Entity Type | Organization
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Legal Business Name | TWIN TOWN CORPORATION
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 3828 W CARSON ST STE 100
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City | TORRANCE
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State | CA
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Zip | 90503-6702
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Country | US
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Telephone | 310-787-1335
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Fax | 310-787-1809
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Provider Business Mailing Address
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Address Line | 4281 KATELLA AVE STE 211
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-6500
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Country | US
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Telephone | 866-594-8844
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Fax | 562-493-1280
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Authorized Official
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Title or Position | CEO
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Name | DAVID PAUL LISONBEE
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Credential |
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Telephone | 562-594-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 190290AP
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License Number State | CA
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