Organization
ECLECTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALFONZA ALLEN KING MS, LPC (CEO)
(706) 566-3169
Entity
Organization
Contact information
Practice address
3846 TRASK DR, COLUMBUS, GA 31903-2937
(706) 566-3169
Mailing address
3846 TRASK DR, COLUMBUS, GA 31903-2937
(706) 566-3169
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC009399
GA
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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