PHYSICIANS CARE CLINIC INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
PHYSICIANS CARE CLINIC INC (EIN 58-2107579)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-05-19
IRS object ID
202501399349301425
Schema version
2024v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-19T13:04:14-04:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN994692590PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Davidson & McGlaun LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1360 Lake Club CircleAddressLine1Txt
CityLavoniaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30553ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582107579EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Physicians Care Clinic IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Michael BaronInCareOfNm
Business Name ControlPHYSBusinessNameControlTxt
Phone4045017940PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12675 N Decatur Road STE 406AddressLine1Txt
CityDecaturCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30033ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL BARON MDPersonNm
Person TitleBoard ChairPersonTitleTxt
Phone4045017940PhoneNum
Signature2025-05-19SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHELLE L DAVIDSONPreparerPersonNm
PTINP01273842PTIN
Phone7708550954PhoneNum
Preparation2025-05-19PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$941,022GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.physicianscareclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTo provide Dekalb Countys low income, uninsured adults quality, comprehensive, non-emergent medical care delivered with excellence, compassion and dignity.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee10TotalEmployeeCnt
Total Volunteers200TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$420,499PYContributionsGrantsAmt
CY Contributions Grants$261,563CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$11,374PYInvestmentIncomeAmt
CY Investment Income$236,357CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$431,873PYTotalRevenueAmt
CY Total Revenue$497,920CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$229,234PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$250,863CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$12,932CYTotalFundraisingExpenseAmt
PY Other Expenses$230,434PYOtherExpensesAmt
CY Other Expenses$192,827CYOtherExpensesAmt
PY Total Expenses$459,668PYTotalExpensesAmt
CY Total Expenses$443,690CYTotalExpensesAmt
PY Revenues Less Expenses-$27,795PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$54,230CYRevenuesLessExpensesAmt
Total Assets BOY$2,412,080TotalAssetsBOYAmt
Total Assets EOY$2,455,018TotalAssetsEOYAmt
Total Liabilities BOY$13,335TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,043TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,398,745NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,452,975NetAssetsOrFundBalancesEOYAmt
MissionTo provide Dekalb Countys low income, uninsured adults quality, comprehensive, non-emergent medical care delivered with excellence, compassion and dignity.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$351,091ExpenseAmt
DescSee Schedule O.Desc
Total Program Service Expenses$351,091TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee10EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonScott ArantPersonNm
Phone4045017940PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12675 N Decatur Road STE 406AddressLine1Txt
CityDecaturCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30033ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
Diana Evans Berman
Member1.000.00Yes (X)$0$0$0
Andrew Dixon
Member1.000.00Yes (X)$0$0$0
Kay Entrekin
Member1.000.00Yes (X)$0$0$0
John Kennedy
Member1.000.00Yes (X)$0$0$0
Stephen Leff
Founder1.000.00Yes (X)$0$0$0
Charles Moody
Member1.000.00Yes (X)$0$0$0
Mark Stern
Member1.000.00Yes (X)$0$0$0
Scott McAuley
Member1.000.00Yes (X)$0$0$0
Dennis Disantis
Member1.000.00Yes (X)$0$0$0
Michael Norman
Member1.000.00Yes (X)$0$0$0
Christine Po
Member1.000.00Yes (X)$0$0$0
Melissa Cobbs
Medical Director1.000.00Yes (X)$0$0$0
Scott Arant
Treasurer1.000.00Yes (X)$0$0$0Yes (X)
Gary Botstein
Emeritus1.000.00Yes (X)$0$0$0Yes (X)
Michael Baron
Board Chair1.000.00Yes (X)$0$0$0Yes (X)
Sharon Gantt
Executive Director40.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$261,563AllOtherContributionsAmt
Noncash Contributions$118,705NoncashContributionsAmt
Total Contributions$261,563TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$52,588TotalRevenueColumnAmt
Related Or Exempt Func Income$52,588RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$626,871SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$432,833SecuritiesAmt
Other$10,269OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$194,038SecuritiesAmt
Other-$10,269OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$183,769TotalRevenueColumnAmt
Related Or Exempt Func Income$183,769RelatedOrExemptFuncIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$497,920TotalRevenueColumnAmt
Related Or Exempt Func Income$236,357RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$196,644TotalAmt
Program Services$147,483ProgramServicesAmt
Management And General$49,161ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$39,252TotalAmt
Program Services$29,439ProgramServicesAmt
Management And General$9,813ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,967TotalAmt
Program Services$11,225ProgramServicesAmt
Management And General$3,742ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$16,247TotalAmt
Program Services$4,479ProgramServicesAmt
Management And General$11,768ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,021TotalAmt
Fundraising$6,021FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,717TotalAmt
Program Services$2,055ProgramServicesAmt
Management And General$198ManagementAndGeneralAmt
Fundraising$1,464FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,035TotalAmt
Program Services$3,350ProgramServicesAmt
Management And General$1,685ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,729TotalAmt
Program Services$1,729ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$125TotalAmt
Management And General$125ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$491TotalAmt
Management And General$491ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$10,355TotalAmt
Program Services$7,735ProgramServicesAmt
Management And General$2,620ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
Medical supplies$133,325$133,325
Volunteer costs$3,937$3,937
Program Services$3,981$3,981
Website$5,447$5,447

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,417TotalAmt
Program Services$2,353ProgramServicesAmt
Management And General$64ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$443,690TotalAmt
Program Services$351,091ProgramServicesAmt
Management And General$79,667ManagementAndGeneralAmt
Fundraising$12,932FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$474,514BOYAmt
EOY$76,472EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$11,301BOYAmt
EOY$11,301EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,408BOYAmt
EOY$2,408EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,165LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$29,633LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,022BOYAmt
EOY$532EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,922,835BOYAmt
EOY$2,364,305EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,412,080BOYAmt
EOY$2,455,018EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,835BOYAmt
EOY$2,043EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,500BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,335BOYAmt
EOY$2,043EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,398,745BOYAmt
EOY$2,452,975EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,398,745BOYAmt
EOY$2,452,975EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,412,080BOYAmt
EOY$2,455,018EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$54,230ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$446,898CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$203,872CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$278,851CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$287,426CurrentTaxYearMinus1YearAmt
Current Tax Year$142,858CurrentTaxYearAmt
Total$1,359,905TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$104,576CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$133,073CurrentTaxYearMinus1YearAmt
Total$237,649TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$446,898CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$203,872CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$383,427CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$420,499CurrentTaxYearMinus1YearAmt
Current Tax Year$142,858CurrentTaxYearAmt
Total$1,597,554TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,597,554PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$272,480CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$216,812CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,444CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$70,366CurrentTaxYearMinus1YearAmt
Current Tax Year$246,626CurrentTaxYearAmt
Total$883,728TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$272,480CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$216,812CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,444CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$70,366CurrentTaxYearMinus1YearAmt
Current Tax Year$246,626CurrentTaxYearAmt
Total$883,728TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$719,378CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$420,684CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$460,871CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$490,865CurrentTaxYearMinus1YearAmt
Current Tax Year$389,484CurrentTaxYearAmt
Total$2,481,282TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.64380PublicSupportCY509Pct
Public Support PY5090.84590PublicSupportPY509Pct
Investment Income CY0.36000InvestmentIncomeCYPct
Investment Income PY0.15000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests PY509Yes (X)ThirtyThrPctSuprtTestsPY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,169OtherCostOrOtherBasisAmt
Depreciation$13,637DepreciationAmt
Book Value$532BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,996OtherCostOrOtherBasisAmt
Depreciation$15,996DepreciationAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$532TotalBookValueLandBuildingsAmt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution12ContributionCnt
Noncash Contributions Rpt F990$118,705NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11The organizations accountant provides a copy of Form 990 to the Board of Directors for review and approval prior to filing.
Conflict of interest policy compliance Part VI line 12cBoard of Directors sign a conflict of interest statement annually. This statement requires the directors to disclose any potential conflicts that may exist.
CEO executive director top management comp Part VI line 15aIn setting compensation, the organization may consider, among other things, external labor market rates, equuitable relationship with other jobs within the organization, and the organizations ability to pay. Each employee may be eligible for a salary review at the beginning of each fiscal year. The Board of Directors will determine the executive directors salary.
Governing documents etc available to public Part VI line 19The organizations accountant provides a copy of Form 990 specifically for public inspection. This copy is available upon request.
List of other fees for services expenses Part IX line 11gOther fees consist of fees for audit, accounting, grant writing and payroll services.

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