Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mourning Glory Club Inc

Organization Mental Health Occupational Therapist · NPI 1912712381

Mourning Glory Club Inc is a Mental Health Occupational Therapist in Marina del Rey, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7 Fleet St Apt 108
Marina del Rey, CA 90292-5731
Phone: (646) 436-5976
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Occupational Therapist (primary) Taxonomy 225XM0800X

Record details

NPI number1912712381
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Aleksei Archer — Founder · (646) 436-5976
NPI enumeratedFebruary 11, 2025
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025
Mailing address7 Fleet St Apt 108, Marina Del Rey, CA 90292-5731

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