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JULLIET JACKSON
NPI 1922438464
Custodial Care Facility - Adult Care Home in Port Charlotte, FL

Active since November 20, 2013
17345 EDGEWATER DR, PORT CHARLOTTE, FL 33948(941) 766-0175 Get Directions Write a Review

NPPES record last updated: November 20, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Julliet Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JULLIET JACKSON (NPI 1922438464) is an individual adult care home provider in Port Charlotte, Florida, licensed in Florida (6905617) and active in the NPI registry since November 2013.

NPPES Registry Identity

NPI1922438464
Entity TypeIndividualFemale
Primary Taxonomy311ZA0620X
Provider Legal NameJULLIET JACKSON
Location Address17345 EDGEWATER DRPort Charlotte, FL 33948-2343
Mailing Address17345 Edgewater DrPort Charlotte, FL 33948-2343 · (941) 766-0175
Phone(941) 766-0175
Sole ProprietorYes
Enumeration DateNovember 20, 2013
✔ NPI 1922438464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in FL · 6905617
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
17345 EDGEWATER DR, Port Charlotte, FL 33948
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Other Identifiers 1

Medicaid142038100FL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Julliet Jackson's NPI number?

The NPI number for Julliet Jackson is 1922438464. It was assigned to this individual provider in the NPPES registry on November 20, 2013.

Where is Julliet Jackson located?

Julliet Jackson practices at 17345 Edgewater Dr, Port Charlotte, FL 33948. The listed phone number is (941) 766-0175.

What is Julliet Jackson's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Julliet Jackson was last updated on November 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.