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Organization
NOVACARE CONNECT LLC
Active
Organization
NOVACARE CONNECT LLC
Active
Other names
Juicy Samurai Med Spa and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
ZEKIELA RILEY RN (OWNER)
(940) 300-4858
Entity
Organization
Contact information
Practice address
209 S SHADY SHORES DR STE 300-2004, LAKE DALLAS, TX 75065-2973
(940) 300-4858
Mailing address
209 S SHADY SHORES DR STE 300-2004, LAKE DALLAS, TX 75065-2973
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
NULL
163WN1003X
Nutrition Support Registered Nurse
—
—
251E00000X
Home Health Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/15/2025
Last updated
10/22/2025
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