MEDICARE: EL FUTURO, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043449093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL FUTURO, INC

Provider Business Mailing Address
First Line	:	136 E CHAPEL HILL ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-3202
Country	:	US
Telephone Number	:	919-688-7101
Fax Number	:	919-688-7102

Provider Business Practice Location Address
First Line	:	2020 CHAPEL HILL RD.
Second Line	:	STE 23
City	:	DURHAM
State	:	NC
Zip	:	27707-2770
Country	:	US
Telephone Number	:	919-968-8710
Fax Number	:	919-688-7102

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. DAVID LUKE SMITH
Credential	:	MD
Telephone Number	:	919-688-7101

Provider Enumeration Date	:	07/13/2009
Last Update Date	:	01/14/2019

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Directions to “EL FUTURO, INC ” Practice Location

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