Organization Active NPI

Phoenix Developmental Services, LLC

  • Behavior Analyst
  • Randolph, MA
National Provider Identifier
1528911773
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PHOENIX DEVELOPMENTAL SERVICES, LLC
Practice address
79 Bridle Path Cir
Randolph, MA 02368-4453
Phone
(617) 407-3666
NPI assigned
Feb 17, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Robert A Grigore, BCBANPI 1740880996
Title
Owner/Ceo
Phone
(617) 407-3666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X

Addresses

Primary practice location

79 Bridle Path Cir
Randolph, MA 02368-4453

Mailing address

79 Bridle Path Cir
Randolph, MA 02368-4453
Phone (617) 407-3666

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1528911773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 BRIDLE PATH CIR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684453",
            "telephone_number": "617-407-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BRIDLE PATH CIR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684453",
            "telephone_number": "617-407-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX DEVELOPMENTAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "GRIGORE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "617-407-3666",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.