Healthcare Provider Details

I. General information

NPI: 1063316297
Provider Name (Legal Business Name): CODY COUNCIL ON AGING DBA CODY SENIOR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 16TH ST
CODY WY
82414-3302
US

IV. Provider business mailing address

613 16TH ST
CODY WY
82414-3302
US

V. Phone/Fax

Practice location:
  • Phone: 307-587-6221
  • Fax: 307-587-9254
Mailing address:
  • Phone: 307-587-6221
  • Fax: 307-587-9254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: STEPHANIE A WEED
Title or Position: EXECECUTIVE DIRECTOR
Credential:
Phone: 307-587-6221