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General NPI Number Information
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NPI Number | 1881380814
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Entity Type | Organization
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Legal Business Name | AUTISM CENTER OF SAUK VALLEY, LLC
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1319 N GALENA AVE
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City | DIXON
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State | IL
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Zip | 61021-1009
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Country | US
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Telephone | 815-440-6134
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Fax |
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Provider Business Mailing Address
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Address Line | 751 FOREST PARK DR
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City | DIXON
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State | IL
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Zip | 61021-9553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BCBA/OWNER
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Name | SARAH LEWIS
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Credential |
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Telephone | 815-535-8963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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