MEDICARE: RAPHAH INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1467071050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPHAH INSTITUTE

Provider Business Mailing Address
First Line	:	615 MAIN ST STE B23
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3603
Country	:	US
Telephone Number	:	615-601-1709
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 MAIN ST STE B23
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3603
Country	:	US
Telephone Number	:	615-601-1709
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. TRAVIS CLAYBROOKS
Credential	:
Telephone Number	:	615-601-1709

Provider Enumeration Date	:	04/13/2020
Last Update Date	:	04/13/2020

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Directions to “RAPHAH INSTITUTE ” Practice Location

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