Provider Demographics
NPI:1245192681
Name:MEMORABLE EXPERIENCE COMPASSIONATE CARE LLC
Entity type:Organization
Organization Name:MEMORABLE EXPERIENCE COMPASSIONATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARKECIA
Authorized Official - Middle Name:DWANICA
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:BAS SUPERVIS/ MANG
Authorized Official - Phone:386-453-0238
Mailing Address - Street 1:1450 N US HIGHWAY 1 STE 900
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6628
Mailing Address - Country:US
Mailing Address - Phone:386-256-2988
Mailing Address - Fax:386-256-2800
Practice Address - Street 1:1450 N US HIGHWAY 1 STE 900
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6628
Practice Address - Country:US
Practice Address - Phone:386-256-2988
Practice Address - Fax:386-256-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health