Healthcare Provider Details

I. General information

NPI: 1912816919
Provider Name (Legal Business Name): INDEPENDENCE ABOUND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 RITCHIE HWY STE 2001004
GLEN BURNIE MD
21061-3065
US

IV. Provider business mailing address

7310 RITCHIE HWY STE 2001004
GLEN BURNIE MD
21061-3065
US

V. Phone/Fax

Practice location:
  • Phone: 443-292-3631
  • Fax:
Mailing address:
  • Phone: 443-292-3631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY WAYNE COVINGTON II
Title or Position: PRESIDENT/CEO
Credential:
Phone: 443-292-3631