# GKHAIRSTON II LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHCP010398
- **Other names:** Compassion In-Home Care Services. LLC, Compassion In-Home Care Services LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1447816608
- **Legal business name:** PHCP010398
- **Authorized official:** MR. GREGORY KEITH HAIRSTON RPH,MBA (CEO)
- **Authorized official phone:** (470) 625-2205

## Contact information

- **Practice address:** 320 LANIER AVE W STE 200, FAYETTEVILLE, GA 30214-7443
- **Practice address phone:** (470) 625-2205
- **Practice address fax:** (470) 300-7662
- **Mailing address:** 320 LANIER AVE W STE 200, FAYETTEVILLE, GA 30214-7443
- **Mailing address phone:** (470) 625-2193
- **Mailing address fax:** (470) 300-7662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2019
- **Last updated:** 07/09/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PHCP010398 | STATE OF GA | GA |