Healthcare Provider Details

I. General information

NPI: 1770334658
Provider Name (Legal Business Name): TEAMWORKS COMMUNITY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 PARKER RD SE STE C210
CONYERS GA
30094-6676
US

IV. Provider business mailing address

1775 PARKER RD SE STE C210
CONYERS GA
30094-6676
US

V. Phone/Fax

Practice location:
  • Phone: 770-776-8280
  • Fax:
Mailing address:
  • Phone: 770-776-8280
  • Fax: 678-682-9745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL BEDDARD
Title or Position: NURSE PRACTITIONER
Credential: DNP, PMHNP-BC, FNP-C
Phone: 770-776-8280