Provider Demographics
NPI:1194405530
Name:SKLENICKA, DENISE MARIE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:SKLENICKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MARIE
Other - Last Name:KOWALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36125 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-8603
Mailing Address - Country:US
Mailing Address - Phone:216-407-2235
Mailing Address - Fax:
Practice Address - Street 1:36125 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-8603
Practice Address - Country:US
Practice Address - Phone:216-407-2235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities