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Organization Active NPI

Nacogdoches County Hospital District

Doing business as Memorial Hospital Geriatric Behavioral Health

  • Psychiatric Hospital
  • Nacogdoches, TX
National Provider Identifier
1558754259
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
450508 Issued in TX
Legal business name
NACOGDOCHES COUNTY HOSPITAL DISTRICT
Doing business as
Memorial Hospital Geriatric Behavioral Health
Serenity Pines
Practice address
1204 N Mound St
Nacogdoches, TX 75961-4027
Phone
(936) 564-4611
NPI assigned
Mar 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jane Ann Bridges, CPA
Title
Chief Financial Officer
Phone
(936) 568-8525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 450508 TX Primary

Addresses

Primary practice location

1204 N Mound St
Nacogdoches, TX 75961-4027

Mailing address

1204 N Mound St
Nacogdoches, TX 75961-4027
Phone (936) 564-4611

Other names 2

  • Memorial Hospital Geriatric Behavioral Health Doing business as
  • Serenity Pines Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150508000884 TX Part A Provider - Hospital 0446151328 Practice locations: Nacogdoches, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558754259. Details of each certification follow.

Hospital certification: CCN 45S508

Legal name
NACOGDOCHES COUNTY HOSPITAL DISTRICT
Doing business as
NACOGDOCHES MEMORIAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
1204N Mound St
Nacogdoches, TX 75961-4027
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Hospice of Deep East Te14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nacogdoches County Hospital District Organization, Nacogdoches, TX Operational/Managerial Control Jul 1, 2015 100%
Lynn Lindsey Individual Operational/Managerial ControlCfo Mar 11, 2024 100%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cecil R. Bomar Rehabilitation CenterNacogdoches, TX, CCN 45T508 Hospital Operational/Managerial Control (100%) Mar 11, 2024
Stonecreek Nursing & RehabilitationSan Augustine, TX, CCN 675729 Skilled nursing facility Operational/Managerial Control (100%) Apr 1, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1558754259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "936-568-8525",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TX",
            "license": "450508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital Geriatric Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Pines",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.