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 provides Mental Health Occupational Therapist services 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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