Active NPI
Divine Savior Healthcare, Inc
- Skilled Nursing Facility
- Portage, WI
National Provider Identifier
1801886239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- DIVINE SAVIOR HEALTHCARE, INC
- Practice address
- 2805 Hunters Trail
Dba Aspirus Tivoli Community
Portage, WI 53901-0387 - Phone
- (608) 742-4131
- Fax
- (608) 745-5997
- NPI assigned
- Oct 26, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jerry M Yang
- Title
- SVP & Chief Financial Officer
- Phone
- (715) 847-2526
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2017 | WI | |
| Skilled Nursing Facility | 314000000X | Primary | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X |
Addresses
Primary practice location
2805 Hunters Trail
Dba Aspirus Tivoli Community
Portage, WI 53901-0387
Mailing address
29980 Network PL
Divine Savior Healthcare Extended Care
Chicago, IL 60673-1299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20135100 | Medicaid | WI |
Other names 1
- ASPIRUS TIVOLI COMMUNITY
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761177600000",
"number": "1801886239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29980 NETWORK PL",
"address_2": "DIVINE SAVIOR HEALTHCARE EXTENDED CARE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2805 HUNTERS TRAIL",
"address_2": "DBA ASPIRUS TIVOLI COMMUNITY",
"city": "PORTAGE",
"state": "WI",
"postal_code": "539010387",
"telephone_number": "608-742-4131",
"fax_number": "608-745-5997"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIVINE SAVIOR HEALTHCARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-26",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A",
"authorized_official_last_name": "YANG",
"authorized_official_first_name": "JERRY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "SVP & CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "715-847-2526",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "2017",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20135100",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ASPIRUS TIVOLI COMMUNITY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "ASPIRUS TIVOLI COMMUNITY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Portage, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.