# AUTUMN LEAVES NURSING & REHABILITATION CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Autumn Leaves Nursing & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619958881
- **Authorized official:** MR. TEDDY RAY PRICE (MANAGING MEMBER)
- **Authorized official phone:** (318) 628-4116

## Contact information

- **Practice address:** 342 COUNTRY CLUB RD, WINNFIELD, LA 71483-7084
- **Practice address phone:** (318) 628-4153
- **Practice address fax:** (318) 628-6171
- **Mailing address:** PO BOX 591, WINNFIELD, LA 71483-0591
- **Mailing address phone:** (318) 628-4153
- **Mailing address fax:** (318) 628-6171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 833 | LA | Yes |

## Other

- **Enumeration date:** 11/07/2005
- **Last updated:** 09/12/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1517143 | — | LA |