Provider Demographics
NPI:1710363965
Name:FIFTH COMMANDMENT HOME HEALTHCARE
Entity Type:Organization
Organization Name:FIFTH COMMANDMENT HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ENGELKES
Authorized Official - Suffix:
Authorized Official - Credentials:NHA, CNA
Authorized Official - Phone:904-592-7736
Mailing Address - Street 1:1279 KINGSLEY AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4603
Mailing Address - Country:US
Mailing Address - Phone:904-592-7736
Mailing Address - Fax:904-602-5328
Practice Address - Street 1:1279 KINGSLEY AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4603
Practice Address - Country:US
Practice Address - Phone:904-592-7736
Practice Address - Fax:904-602-5328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health