Provider Demographics
NPI:1790902922
Name:IN MY SHOES, INC.
Entity Type:Organization
Organization Name:IN MY SHOES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-323-0886
Mailing Address - Street 1:310 S WILLIAMS BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-4407
Mailing Address - Country:US
Mailing Address - Phone:520-323-0886
Mailing Address - Fax:520-323-6819
Practice Address - Street 1:240 W NAVAJO RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3514
Practice Address - Country:US
Practice Address - Phone:520-323-0886
Practice Address - Fax:520-323-6819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCSA05CP0184251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health