IDEAL COMMUNITY LIVING NPI 1194688747

NPI Information

  • NPI: 1194688747
  • Provider Name: IDEAL COMMUNITY LIVING
  • Classification: Registered Nurse - 163WD0400X
  • Specialization: Diabetes Educator
  • Entity Type: Organization
  • Address: 3900 W BROWN DEER RD STE C9
    BROWN DEER, WI
    ZIP 53209
  • Phone: (262) 469-1053

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NPI Details

IDEAL COMMUNITY LIVING is a diabetes educator registered nurse in Brown Deer, WI. IDEAL COMMUNITY LIVING NPI is 1194688747. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3900 W BROWN DEER RD STE C9
BROWN DEER, WI
ZIP 53209-220
Phone: (262) 469-1053
Fax: (855) 853-8249

The provider's authorized official is Dana Catrice Perry .
The authorized official title is Owner and has the following contact phone number (262) 469-1053.

The enumeration date for this NPI number is 12/9/2025 and was last updated on 12/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QB0505XNo
2133VN1004XDietitian, RegisteredNutrition, PediatricNo
3133VN1201XDietitian, RegisteredNutrition, Obesity and Weight ManagementNo
4132700000XDietary ManagerNo
5207QD0401XNo
6311500000XAlzheimer Center (Dementia Center)No
7174200000XMealsNo
8251E00000XHome HealthNo
9171R00000XInterpreterNo
10133N00000XNutritionistNo
11133NN1002XNutritionistNutrition, EducationNo
12171400000XHealth and Wellness CoachNo
13103TA0700XPsychologistAdult Development & AgingNo
14405300000XPrevention ProfessionalNo
15163WD0400XRegistered NurseDiabetes EducatorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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