| Maitri Path To Wellness Pllc | |
|
710 Peoria St Peru IL 61354-3351 | |
| (815) 780-0690 | |
| (815) 410-1937 |
| Full Name | Maitri Path To Wellness Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 710 Peoria St, Peru, Illinois |
| Authorized Official Name and Position | Brenden Fasken (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8157800690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maitri Path To Wellness Pllc 710 Peoria St Peru IL 61354-3351 Ph: (815) 780-0690 | Maitri Path To Wellness Pllc 710 Peoria St Peru IL 61354-3351 Ph: (815) 780-0690 |
| NPI Number | 1053018242 |
|---|---|
| Provider Enumeration Date | 02/08/2023 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053018242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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