Provider Demographics
NPI:1962106112
Name:MORNING GLORY FACILITY PLUS, INC
Entity type:Organization
Organization Name:MORNING GLORY FACILITY PLUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCEO
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
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 1:13243 CORRIGAN AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-4846
Practice Address - Country:US
Practice Address - Phone:562-306-5696
Practice Address - Fax:562-306-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities