MEDICARE: TWIN TOWN CORPORATION

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	300128DP	CA

General Provider Information

NPI Number	:	1881020626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN TOWN CORPORATION

Provider Business Mailing Address
First Line	:	4281 KATELLA AVE STE 211
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-6500
Country	:	US
Telephone Number	:	866-594-8844
Fax Number	:	562-493-1280

Provider Business Practice Location Address
First Line	:	23521 PASEO DE VALENCIA STE B5
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3125
Country	:	US
Telephone Number	:	949-540-0170
Fax Number	:	949-540-0173

Authorized Official
Title or Position	:	CEO/ PRESIDENT
Name	:	MR. DAVID PAUL LISONBEE
Credential	:
Telephone Number	:	310-629-9669

Provider Enumeration Date	:	09/25/2013
Last Update Date	:	12/30/2025

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