Provider Demographics
NPI:1184518904
Name:RAPHA MEDICAL PSYCH SERVICES
Entity type:Organization
Organization Name:RAPHA MEDICAL PSYCH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TILAHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-249-9752
Mailing Address - Street 1:179 LONDON CT
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-3367
Mailing Address - Country:US
Mailing Address - Phone:434-249-9752
Mailing Address - Fax:803-650-3964
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8835
Practice Address - Country:US
Practice Address - Phone:434-249-9752
Practice Address - Fax:803-650-3964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty