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General NPI Number Information
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NPI Number | 1194688747
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Entity Type | Organization
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Legal Business Name | IDEAL COMMUNITY LIVING
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/13/2025
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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 CATRICE PERRY
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Credential |
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Telephone | 414-698-0990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 174200000X
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Taxonomy Name | Meals Provider
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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 | 171R00000X
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Taxonomy Name | Interpreter
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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 | 133N00000X
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Taxonomy Name | 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 | 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 #9
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 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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Taxonomy #11
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational 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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 176P00000X
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Taxonomy Name | Funeral Director
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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