Provider Demographics
NPI:1528393584
Name:EL FUTURO, INC.
Entity Type:Organization
Organization Name:EL FUTURO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LUCAS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-338-1939
Mailing Address - Street 1:110 W. MAIN ST.
Mailing Address - Street 2:2H
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510
Mailing Address - Country:US
Mailing Address - Phone:919-338-1939
Mailing Address - Fax:919-338-2729
Practice Address - Street 1:319 E 3RD ST
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3231
Practice Address - Country:US
Practice Address - Phone:919-688-7101
Practice Address - Fax:919-688-7102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL FUTURO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-08
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005688Medicaid