Provider Demographics
NPI:1376326264
Name:MORNING GLORY FACILITY PLUS II, INC.
Entity Type:Organization
Organization Name:MORNING GLORY FACILITY PLUS II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARCEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-345-5036
Mailing Address - Street 1:15411 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-4301
Mailing Address - Country:US
Mailing Address - Phone:310-345-5036
Mailing Address - Fax:310-327-3129
Practice Address - Street 1:8662 SPRINGER ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2619
Practice Address - Country:US
Practice Address - Phone:310-327-3237
Practice Address - Fax:310-327-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities