Healthcare Provider Details

I. General information

NPI: 1922965482
Provider Name (Legal Business Name): BEAR GRASS CHARTER SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6344 E BEAR GRASS RD
BEAR GRASS NC
27892-8434
US

IV. Provider business mailing address

6344 E BEAR GRASS RD
BEAR GRASS NC
27892-8434
US

V. Phone/Fax

Practice location:
  • Phone: 252-789-1010
  • Fax: 252-789-1014
Mailing address:
  • Phone: 252-789-1010
  • Fax: 252-789-1014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name: STACEY WIGGINS
Title or Position: FINANCE
Credential:
Phone: 252-789-1010