Healthcare Provider Details

I. General information

NPI: 1508728718
Provider Name (Legal Business Name): FAITHFUL CROWN HOPE CENTER OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17821 W GETTY DR
GOODYEAR AZ
85338-4852
US

IV. Provider business mailing address

17821 W GETTY DR
GOODYEAR AZ
85338-4852
US

V. Phone/Fax

Practice location:
  • Phone: 402-320-1182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: SABRINA BROWN
Title or Position: OWNER
Credential:
Phone: 402-320-1182