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MAITRI PATH TO WELLNESS PLLC
NPI 1184359168
Clinic/Center - Rehabilitation, Substance Use Disorder in Peru, IL

Active since July 22, 2022
710 PEORIA ST, PERU, IL 61354(815) 780-0690(815) 410-1937 Get Directions Write a Review

NPPES record last updated: April 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 17, 2024, May 11, 2023, Jul 22, 2022 (3 updates tracked since 2022).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Rehabilitation, Substance Use Disorder

About MAITRI PATH TO WELLNESS PLLC

This page provides the complete NPI Profile along with additional information for Maitri Path To Wellness Pllc, a provider established in Peru, Illinois operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1184359168 assigned on July 2022. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Brenden Fasken (Chief Operating Officer)

NPI
1184359168 Verify this NPI
Provider Name
MAITRI PATH TO WELLNESS PLLC
Entity Type
Organization
Location Address
710 PEORIA ST PERU, IL 61354
Location Phone
(815) 780-0690
Location Fax
(815) 410-1937
Mailing Address
710 PEORIA ST PERU, IL 61354
Mailing Phone
(815) 780-0690
Mailing Fax
(815) 410-1937
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-22-2022
Last Update Date
04-17-2024
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rehabilitation, Substance Use Disorder

Taxonomy Code
261QR0405X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRENDEN FASKEN

Authorized Official Title
CHIEF OPERATING OFFICER
Authorized Official Phone
(815) 780-0690

Reviews for MAITRI PATH TO WELLNESS PLLC

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Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

SHANNA O'BRIEN LSW
Social Worker
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
VANESSA ABELLAN CADC
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
BRENDEN FASKEN
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MAITRI PATH TO WELLNESS PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
KAYLA MARIE FALLEN
Counselor (Mental Health)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MAITRI PATH TO WELLNESS PLLC
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
WELLNESS AND RECOVERY WITH MAITRI, INC. NFP
Clinic/Center (Mental Health (Including Community Mental Health Center))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
PATRICIA MICHAELS
Counselor (Mental Health)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
LISA KELLY JONES
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
VICTORIA MERRITT WINTERROSE
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
TAMARA LEIGH BEABER LSW
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MS. PATRICIA ALINA PELAEZ CADC
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
RACHEL MARIE EDGCOMB CADC
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MORGAN TORMAN LSW
Social Worker
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690

Frequently Asked Questions

What is MAITRI PATH TO WELLNESS PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1184359168, enumerated as an "organization" on July 22, 2022.

Where is the provider located?

The provider is located at 710 PEORIA ST PERU, IL 61354 and the phone number is (815) 780-0690.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.