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Organization
AUTUMN LAKE LLC
Active
Organization
AUTUMN LAKE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTAL RILEY (COO)
(225) 888-5881
Entity
Organization
Contact information
Practice address
11758 S HARRELLS FERRY RD STE C, BATON ROUGE, LA 70816-2365
(225) 246-2740
(225) 367-4687
Mailing address
11758 S HARRELLS FERRY RD STE C, BATON ROUGE, LA 70816-2365
(225) 246-2740
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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