Organization
DIVINE SAVIOR HEALTHCARE, INC
Active
Other names
ASPIRUS TIVOLI COMMUNITY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERRY M YANG (SVP & CHIEF FINANCIAL OFFICER)
(715) 847-2526
Entity
Organization
Contact information
Practice address
2805 HUNTERS TRAIL, DBA ASPIRUS TIVOLI COMMUNITY, PORTAGE, WI 53901-0387
(608) 742-4131
(608) 745-5997
Mailing address
29980 NETWORK PL, DIVINE SAVIOR HEALTHCARE EXTENDED CARE, CHICAGO, IL 60673-1299
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
2017
WI
314000000X
Skilled Nursing Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20135100
—
WI
Enumeration date
10/26/2005
Last updated
10/23/2025
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