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General NPI Number Information
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NPI Number | 1043148679
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Entity Type | Organization
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Legal Business Name | ELLEE RESIDENTIAL CARE 5 LLC
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 25708 OAK CT
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City | MORENO VALLEY
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State | CA
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Zip | 92557-6628
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Country | US
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Telephone | 408-930-0790
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Fax |
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Provider Business Mailing Address
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Address Line | 502 CAJON ST
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City | REDLANDS
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State | CA
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Zip | 92373-5904
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Country | US
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Telephone | 909-557-4422
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALEX LENKE
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Credential |
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Telephone | 909-335-1818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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