Provider Demographics
NPI:1871632091
Name:FIFTH COMMANDMENT CORP
Entity Type:Organization
Organization Name:FIFTH COMMANDMENT CORP
Other - Org Name:DBA HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MATTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-392-5019
Mailing Address - Street 1:3910 CAUGHEY RD
Mailing Address - Street 2:STE 220
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4096
Mailing Address - Country:US
Mailing Address - Phone:814-464-9200
Mailing Address - Fax:814-464-9202
Practice Address - Street 1:3910 CAUGHEY RD
Practice Address - Street 2:STE 220
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4096
Practice Address - Country:US
Practice Address - Phone:814-464-9200
Practice Address - Fax:814-464-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA372600000X, 3747P1801X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019039730001Medicaid