Healthcare Provider Details

I. General information

NPI: 1043178015
Provider Name (Legal Business Name): JENNINGS O'NEIL CAREER ACADEMY AND WORKFORCE DEVELOPMENT PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2712-B FREEDOM DRIVE
CHARLOTTE NC
28208
US

IV. Provider business mailing address

2712-B FREEDOM DRIVE
CHARLOTTE NC
28208
US

V. Phone/Fax

Practice location:
  • Phone: 704-617-4971
  • Fax:
Mailing address:
  • Phone: 704-617-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE JENNINGS-ANDERSON
Title or Position: CHIEF EXECUTIVE DIRECTOR
Credential:
Phone: 704-617-4791