Organization
WAI-IAM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELYN LIEBNER BBA (EXECUTIVE DIRECTOR)
(517) 897-9001
Entity
Organization
Contact information
Practice address
217 N SYCAMORE ST, LANSING, MI 48933-1033
(517) 819-6569
(517) 580-7128
Mailing address
217 N SYCAMORE ST, LANSING, MI 48933-1033
(517) 897-9001
(517) 580-7128
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
M318510
MI
324500000X
Substance Abuse Rehabilitation Facility
Primary
SA0330351
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M318510
SUPPORTIVE RECOVERY HOUSING
MI
Enumeration date
07/01/2016
Last updated
04/23/2018
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