Organization
MAITRI PATH TO WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDEN FASKEN (CHIEF OPERATING OFFICER)
(815) 780-0690
Entity
Organization
Contact information
Practice address
710 PEORIA ST, PERU, IL 61354-3351
(815) 780-0690
(815) 410-1937
Mailing address
710 PEORIA ST, PERU, IL 61354-3351
(815) 780-0690
(815) 410-1937
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
04/17/2024
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