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General NPI Number Information
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NPI Number | 1174487763
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Entity Type | Organization
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Legal Business Name | GREENHEART LIVING LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 3900 W BROWN DEER RD STE C6
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City | BROWN DEER
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State | WI
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Zip | 53209-1220
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Country | US
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Telephone | 262-469-1053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1111
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City | WEST BEND
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State | WI
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Zip | 53095-8611
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Country | US
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Telephone | 414-698-0990
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANA PERRY
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Credential |
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Telephone | 262-469-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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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 | 174H00000X
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Taxonomy Name | Health Educator
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 364SH1100X
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Taxonomy Name | Holistic Clinical Nurse Specialist
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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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 | 175L00000X
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Taxonomy Name | Homeopath
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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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 | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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