MEDICARE: TRIANGLE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1699642595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIANGLE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

Provider Business Mailing Address
First Line	:	801 ATLANTIC CITY BLVD UNIT 16
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-8003
Country	:	US
Telephone Number	:	702-338-8772
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 ATLANTIC CITY BLVD STE 2
Second Line	:
City	:	BEACHWOOD
State	:	NJ
Zip	:	08722-2972
Country	:	US
Telephone Number	:	702-338-8772
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD P. HOLLIGAN
Credential	:
Telephone Number	:	702-338-8772

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	04/15/2026

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