CYPRESS CREEK RESIDENTIAL CARE LLC
NPI 1366564676
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Fairdealing, MO

Q: What is Cypress Creek Residential Care LLC's NPI number?

The NPI number for Cypress Creek Residential Care LLC is 1366564676. It was assigned to this organization in the NPPES registry on April 6, 2007.

Q: What is Cypress Creek Residential Care LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Active since April 06, 2007

546 RIPLEY BB-1, FAIRDEALING, MO 63939(573) 351-1221 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Cypress Creek Residential Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CYPRESS CREEK RESIDENTIAL CARE LLC (NPI 1366564676) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Fairdealing, Missouri and active in the NPI registry since April 2007. The organization lists Traci Wagner, Owner, as its authorized official.

NPPES Registry Identity

NPI1366564676

Entity TypeOrganization

Primary Taxonomy320900000X

Legal Business NameCYPRESS CREEK RESIDENTIAL CARE LLC

Location Address546 RIPLEY BB-1Fairdealing, MO 63939-8003

Mailing Address546 Ripley Bb-1Fairdealing, MO 63939-8003 · (573) 351-1221

Phone(573) 351-1221

Organization SubpartNo

Authorized OfficialTraci WagnerOwner · (573) 351-1221

Enumeration DateApril 6, 2007

Last NPPES UpdateOctober 17, 2024

NPPES CertifiedOctober 17, 2024

✔ NPI 1366564676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X

Also ListedRespite CareTaxonomy 385H00000X

546 RIPLEY BB-1, Fairdealing, MO 63939

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Other Identifiers 1

Medicaid853295210MO

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cypress Creek Residential Care LLC's NPI number?

The NPI number for Cypress Creek Residential Care LLC is 1366564676. It was assigned to this organization in the NPPES registry on April 6, 2007.

Where is Cypress Creek Residential Care LLC located?

Cypress Creek Residential Care LLC is located at 546 Ripley Bb-1, Fairdealing, MO 63939. The listed phone number is (573) 351-1221.

What is Cypress Creek Residential Care LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Cypress Creek Residential Care LLC was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.