Healthcare Provider Details

I. General information

NPI: 1164169256
Provider Name (Legal Business Name): MCLENDON MANOR ADVOCACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5739 W CORTARO CROSSING DR
TUCSON AZ
85742-8125
US

IV. Provider business mailing address

2036 N GILBERT RD STE 2-491
MESA AZ
85203-2139
US

V. Phone/Fax

Practice location:
  • Phone: 520-476-4142
  • Fax:
Mailing address:
  • Phone: 623-666-3673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SHANTE M MCLENDON
Title or Position: OWNER
Credential:
Phone: 623-666-3673