Organization
DIVINE SAVIOR HEALTHCARE INC
Active
Other names
Aspirus Tivoli Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY M YANG (SVP & CHIEF FINANCIAL OFFICER)
(715) 847-2526
Entity
Organization
Contact information
Practice address
2817 NEW PINERY ROAD, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-0387
(608) 742-4131
(608) 742-6098
Mailing address
29980 NETWORK PL, CHICAGO, IL 60673-1299
(715) 847-2304
(715) 843-1188
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
328
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41533500
—
WI
Enumeration date
04/18/2006
Last updated
06/14/2024
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