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Organization
RAPHA MEDICAL CENTER LLC
Active
Organization
RAPHA MEDICAL CENTER LLC
Active
Other names
Rapha Medical Psych Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TILAHUN MEKONNEN GOSHU DNP/PHD (CEO)
(434) 249-9752
Entity
Organization
Contact information
Practice address
600 PETER JEFFERSON PKWY STE 110, CHARLOTTESVILLE, VA 22911-8835
(434) 249-9752
(803) 650-3964
Mailing address
600 PETER JEFFERSON PKWY STE 110, CHARLOTTESVILLE, VA 22911-8835
(434) 249-9752
(803) 650-3964
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QU0200X
Urgent Care Clinic/Center
Primary
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/21/2025
Last updated
05/23/2025
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