Healthcare Provider Details

I. General information

NPI: 1538092432
Provider Name (Legal Business Name): THRIVEORA COMMUNITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5653 COLUMBIA PIKE STE 200
FALLS CHURCH VA
22041-2873
US

IV. Provider business mailing address

5653 COLUMBIA PIKE STE 200
FALLS CHURCH VA
22041-2873
US

V. Phone/Fax

Practice location:
  • Phone: 202-322-7422
  • Fax:
Mailing address:
  • Phone: 202-322-7422
  • 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

VIII. Authorized Official

Name: MAKA IBRAHIM
Title or Position: OWNER
Credential:
Phone: 202-322-7422