Healthcare Provider Details

I. General information

NPI: 1245192681
Provider Name (Legal Business Name): MEMORABLE EXPERIENCE COMPASSIONATE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 N US HIGHWAY 1 STE 900
ORMOND BEACH FL
32174-6628
US

IV. Provider business mailing address

1450 N US HIGHWAY 1 STE 900
ORMOND BEACH FL
32174-6628
US

V. Phone/Fax

Practice location:
  • Phone: 386-256-2988
  • Fax: 386-256-2800
Mailing address:
  • Phone: 386-256-2988
  • Fax: 386-256-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARKECIA DWANICA ENGLISH
Title or Position: CEO
Credential: B.A.S SUPERVIS/ MANG
Phone: 386-453-0238