Healthcare Provider Details

I. General information

NPI: 1295667533
Provider Name (Legal Business Name): FORWARD BOUND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 BOXWOOD RD
WILMINGTON DE
19804-1825
US

IV. Provider business mailing address

5 TIMBERLANE DR
NORTH EAST MD
21901-4425
US

V. Phone/Fax

Practice location:
  • Phone: 302-299-2687
  • Fax:
Mailing address:
  • Phone: 302-333-7320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIO VERDEN JR.
Title or Position: CO-OWNER
Credential:
Phone: 302-299-2687