| Organization Name: | EAGLE'S LANDING CHRISTIAN COUNSELING CENTER, INC. |
| NPI Number: | 1093955205 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA DENICE COLSON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 204 W Campground Rd Mcdonough |
| State: | GA US |
| Postal Code: | 302538002 |
| Phone Number: | 7708982966 |
| Fax Number: | 7708980366 |
| NPI Enumeration Date: | 02/27/2009 |
| NPI Last Update Date: | 03/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 3717 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |