Provider Demographics
NPI:1770459513
Name:JET RECOVERY LLC
Entity type:Organization
Organization Name:JET RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TALETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENECAL
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, CAS
Authorized Official - Phone:719-431-9831
Mailing Address - Street 1:1250 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-4462
Mailing Address - Country:US
Mailing Address - Phone:719-431-9831
Mailing Address - Fax:
Practice Address - Street 1:1250 SHORT ST
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-4462
Practice Address - Country:US
Practice Address - Phone:719-431-9831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty