Ellis Cottage Assisted Living LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

ELLIS COTTAGE ASSISTED LIVING LLC

Practice address

28310 Ellis Ave
Menifee, CA 92585-9009

Phone

(951) 878-7027

NPI assigned

Feb 11, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dante Bautista

Title

Manager

Phone

(951) 878-7027

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1902611585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28310 ELLIS AVE",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925859009",
            "telephone_number": "951-878-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28310 ELLIS AVE",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925859009",
            "telephone_number": "951-878-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS COTTAGE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "DANTE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "951-878-7027"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in Menifee, CA
• Providers in Menifee, CA by specialty
• Physical Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.