MOURNING GLORY CLUB INC NPI 1912712381

NPI Information

  • NPI: 1912712381
  • Provider Name: MOURNING GLORY CLUB INC
  • Classification: Occupational Therapist - 225XM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 7 FLEET ST APT 108
    MARINA DEL REY, CA
    ZIP 90292
  • Phone: (646) 436-5976

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NPI Details

MOURNING GLORY CLUB INC is a mental health occupational therapist in Marina Del Rey, CA. The provider is occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to engage in normal daily occupations (work, home, family life, school, leisure). Occupational therapists provide particular emphasis on interventions that result in improved quality of life and decrease hospitalization. MOURNING GLORY CLUB INC NPI is 1912712381. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7 FLEET ST APT 108
MARINA DEL REY, CA
ZIP 90292-731
Phone: (646) 436-5976

The provider's authorized official is Aleksei Archer .
The authorized official title is Founder and has the following contact phone number (646) 436-5976.

The enumeration date for this NPI number is 2/11/2025 and was last updated on 2/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225XM0800XOccupational TherapistMental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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