Provider Demographics
NPI:1003788076
Name:A GENIUS MIND ACADEMY
Entity type:Organization
Organization Name:A GENIUS MIND ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDCALF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-390-5968
Mailing Address - Street 1:11243 POINTER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-0014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11243 POINTER RIDGE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-0014
Practice Address - Country:US
Practice Address - Phone:704-390-5968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities