OrganizationAlta Vista Integrated Life Services(Alta Vista School)Social WorkerBehavioral Health & Social Service ProvidersPractice Address7282 Stinson Ave Ste B, Gig Harbor, WA 98335-4930(855) 201-8141(360) 900-7190PECOS EnrollmentBased on the most recent information from CMS, provider Alta Vista Integrated Life Services does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1538726252Provider TypeOrganizationFull NameAlta Vista Integrated Life ServicesOther NameAlta Vista SchoolSubpartNoEnumeration Date5/29/2019Last Updated12/12/2024Contact InformationPractice LocationPractice Address7282 Stinson Ave Ste B, Gig Harbor, WA 98335-4930Phone(855) 201-8141FaxUnlisted FaxMailing LocationMailing AddressPO Box 10, Burley, WA 98322-0010Phone(360) 900-7190FaxUnlisted FaxAuthorized OfficialNameRuiz, Ashley (Executive Director)Phone(360) 900-7190Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode103K00000XDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode261QM0801XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID2142431DescriptionMedicaidIssuerUnlistedWashington