Healthcare Provider Details

I. General information

NPI: 1811816036
Provider Name (Legal Business Name): THRIVEPATH COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BELAIRE AVE STE 200
CHESAPEAKE VA
23320-4783
US

IV. Provider business mailing address

555 BELAIRE AVE STE 210-2006
CHESAPEAKE VA
23320-4783
US

V. Phone/Fax

Practice location:
  • Phone: 757-994-4555
  • Fax:
Mailing address:
  • Phone: 757-994-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TEVRAN MATIAS GRIFFIN
Title or Position: OWNER/CEO/EXECUTIVE DIRECTOR
Credential:
Phone: 757-994-4555