Organization
GKHAIRSTON II LLC
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
Legal business name
PHCP010398
Authorized official
MR. GREGORY KEITH HAIRSTON RPH,MBA (CEO)
(470) 625-2205
Entity
Organization
Contact information
Practice address
320 LANIER AVE W STE 200, FAYETTEVILLE, GA 30214-7443
(470) 625-2205
(470) 300-7662
Mailing address
320 LANIER AVE W STE 200, FAYETTEVILLE, GA 30214-7443
(470) 625-2193
(470) 300-7662
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHCP010398
STATE OF GA
GA
Enumeration date
05/14/2019
Last updated
07/09/2019
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