Healthcare Provider Details

I. General information

NPI: 1336061316
Provider Name (Legal Business Name): TRUE ANGELS PRIVATE HOMEHEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CHARTER LN APT 604
MACON GA
31210-4554
US

IV. Provider business mailing address

200 CHARTER LN APT 604
MACON GA
31210-4554
US

V. Phone/Fax

Practice location:
  • Phone: 478-877-6956
  • Fax:
Mailing address:
  • Phone: 478-877-6956
  • Fax:

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: MRS. LAKECIA PETE-CRAYTON
Title or Position: CNA/ OWNER
Credential: CNA
Phone: 478-877-6956