# RAPHA MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rapha Medical Psych Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255123444
- **Authorized official:** DR. TILAHUN MEKONNEN GOSHU DNP/PHD (CEO)
- **Authorized official phone:** (434) 249-9752

## Contact information

- **Practice address:** 600 PETER JEFFERSON PKWY STE 110, CHARLOTTESVILLE, VA 22911-8835
- **Practice address phone:** (434) 249-9752
- **Practice address fax:** (803) 650-3964
- **Mailing address:** 600 PETER JEFFERSON PKWY STE 110, CHARLOTTESVILLE, VA 22911-8835
- **Mailing address phone:** (434) 249-9752
- **Mailing address fax:** (803) 650-3964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |
| 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