Tri-State Treatment,llc
NPI 1780036210 · Substance Abuse Rehabilitation Facility · Wildwood, GA
Enrolled with Medicare as Part B Supplier - Opioid Treatment Program (otp) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1780036210
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Melissa Hancock, Administrator(423) 428-0045
- License
- NTP001071 (GA)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
9 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,578 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Take-Home Supply of Methadone; Up to 7 Additional Day Supply (provision of the Services By a Medicare-Enrolled Opioid Treatment Program); List Separately in Addition to Code for Primary ProcedureG2078 | 1,018 | $39 |
| Medication Assisted Treatment, Methadone; Weekly Bundle Including Dispensing And/Or Administration, Substance Use Counseling, Individual and Group Therapy, and Toxicology Testing, If Performed (provision of the Services By a Medicare-Enrolled Opioid TreatmG2067 | 560 | $240 |
Typical Medicare-allowed amounts for these services range $39–$240 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-07-08
- Last updated
- 2024-03-20
- Certified
- 2024-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.