Lifevault Bio, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LIFEVAULT BIO, INC.

Practice address

179 Bear Hill Rd
Waltham, MA 02451-1063

Phone

(800) 772-0593

NPI assigned

Aug 16, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Trevor Perry

Title

Ceo

Phone

(800) 772-0593

Specialties & licenses 1

Addresses

Other names 1

• GoodCell Doing business as

Electronic endpoints 1

Tax ID family

Goodcell2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lifevault Bio, Inc.

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1922726223
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1053087585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 BEAR HILL RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511063",
            "telephone_number": "800-772-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 BEAR HILL RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511063",
            "telephone_number": "800-772-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEVAULT BIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-772-0593"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.goodcell.com",
            "affiliation": "N",
            "address_1": "179 Bear Hill Rd",
            "city": "Waltham",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024511063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GoodCell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jared S Lewis, DPT
• Weichun Li, DMD
• Elsa L. Lichman, LICSW
• Life Centered Therapy LLC
• Life Skills and Family Initiative Inc
• Rebecca Liggett
• Marilyn Buzon Liguid, OTR/L
• Allison Liguori, LCSW
• James S Liljestrand, M.D.
• Khai Lim, DMD

• Clinical Medical Laboratory in Waltham, MA
• Providers in Waltham, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.