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
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/15/2025
Last updated
10/22/2025
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