EBENZER MEDICAL OUTREACH INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
EBENZER MEDICAL OUTREACH INC (EIN 55-0745033)
Tax period
2023-07-01 to 2024-06-30
Filed
2025-05-12
IRS object ID
202511329349300221
Schema version
2023v6.0
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)
Return2025-05-12T08:48:42-04:00ReturnTs
Tax Period End2024-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550657218PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HESS STEWART & CAMPBELL PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1940 4TH AVE STE 250AddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP257011455ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550745033EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EBENEZER MEDICAL OUTREACH INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEBENBusinessNameControlTxt
Phone3045290753PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAN HAGERPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3045290753PhoneNum
Signature2025-05-02SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrfalseIRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHARLES M MORRIS CPAPreparerPersonNm
PTINP01354970PTIN
Phone3045236464PhoneNum
Preparation2025-05-12PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAN HAGERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,621,192GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EMOHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionPROVIDE MEDICAL SERVICES TO THE UNINSURED.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee15TotalEmployeeCnt
Total Volunteers45TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$2,281,413PYContributionsGrantsAmt
CY Contributions Grants$1,541,114CYContributionsGrantsAmt
PY Program Service Revenue$65,434PYProgramServiceRevenueAmt
CY Program Service Revenue$65,126CYProgramServiceRevenueAmt
PY Investment Income$2,755PYInvestmentIncomeAmt
CY Investment Income$14,542CYInvestmentIncomeAmt
PY Other Revenue$1,025PYOtherRevenueAmt
CY Other Revenue$410CYOtherRevenueAmt
PY Total Revenue$2,350,627PYTotalRevenueAmt
CY Total Revenue$1,621,192CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$358,700PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$390,130CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,150,548PYOtherExpensesAmt
CY Other Expenses$1,284,820CYOtherExpensesAmt
PY Total Expenses$2,509,248PYTotalExpensesAmt
CY Total Expenses$1,674,950CYTotalExpensesAmt
PY Revenues Less Expenses-$158,621PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$53,758CYRevenuesLessExpensesAmt
Total Assets BOY$1,000,617TotalAssetsBOYAmt
Total Assets EOY$1,142,604TotalAssetsEOYAmt
Total Liabilities BOY$185,181TotalLiabilitiesBOYAmt
Total Liabilities EOY$372,044TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$815,436NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$770,560NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE MEDICAL SERVICES TO THE UNINSURED.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,669,567ExpenseAmt
Revenue$65,126RevenueAmt
DescPROVIDES FREE MEDICAL CARE TO THE UNEMPLOYED AND WORKING POOR WHO ARE WITHOUT HEALTH INSURANCE AND ARE AT OR BELOW THE FEDERAL INCOME PROVERTY GUIDELINES. SERVICES PROVIDED INCLUDE GENERAL MEDICINE, BREAST/CERVICAL CANCER SCREENINGS, COUNSELING, LAB AND MEDICINES.Desc
Total Program Service Expenses$1,669,567TotalProgramServiceExpensesAmt
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 EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
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 EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee15EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
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 Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonREBECCA GLASSPersonNm
Phone3045290753PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
REBECCA GLASS
ADMINISTRATO40.00Yes (X)$52,594$0$0
DAN HAGER
EXECUTIVE DI40.00Yes (X)$22,512$0$0
AARON BLEVINS
BOARD MEMBER1.00$0$0$0Yes (X)
RORY CHAPMAN
BOARD MEMBER1.00$0$0$0Yes (X)
FRAN D'EGIDIO
BOARD MEMBER1.00$0$0$0Yes (X)
SARAH DENMAN
BOARD MEMBER1.00$0$0$0Yes (X)
DAVID ELLER
BOARD MEMBER1.00$0$0$0Yes (X)
RAJ KHANNA
BOARD MEMBER1.00$0$0$0Yes (X)
DENISE LANDRY
BOARD MEMBER1.00$0$0$0Yes (X)
SUE MCCLELLAND
BOARD MEMBER1.00$0$0$0Yes (X)
KATHLEEN NAPIER
BOARD MEMBER1.00$0$0$0Yes (X)
STEPHEN PETRANY
INTERIM PRES1.00Yes (X)$0$0$0Yes (X)
CHRISTOPHER PLYBON
BOARD MEMBER1.00$0$0$0Yes (X)
RASHAD SANDERS
BOARD MEMBER1.00$0$0$0Yes (X)
NATHAN WARD
BOARD MEMBER1.00$0$0$0Yes (X)
LEONARD WHITE
BOARD MEMBER1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$75,106TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$298,769GovernmentGrantsAmt
All Other Contributions$1,242,345AllOtherContributionsAmt
Noncash Contributions$977,327NoncashContributionsAmt
Total Contributions$1,541,114TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescBILLINGSDesc
Business621400BusinessCd
Total Revenue Column$65,126TotalRevenueColumnAmt
Related Or Exempt Func Income$65,126RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$65,126TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,542TotalRevenueColumnAmt
Related Or Exempt Func Income$14,542RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$410TotalRevenueColumnAmt
Related Or Exempt Func Income$410RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$410OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,621,192TotalRevenueColumnAmt
Related Or Exempt Func Income$80,078RelatedOrExemptFuncIncomeAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$75,106TotalAmt
Program Services$75,106ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$282,904TotalAmt
Program Services$282,904ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$32,120TotalAmt
Program Services$32,120ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,837TotalAmt
Program Services$1,837ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$29,181TotalAmt
Program Services$29,181ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$95,851TotalAmt
Program Services$95,851ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,171TotalAmt
Program Services$3,171ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$10,704TotalAmt
Program Services$10,704ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$24,750TotalAmt
Program Services$24,750ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,767TotalAmt
Program Services$6,767ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
CONTRIBUTED SUPPLIES & EQ$977,327$977,327
OTHER PROFESSIONAL SERVIC$67,427$67,427
SUPPLIES$46,297$46,297
EQUIPMENT RENTAL/PURCHASE$12,166$12,166

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,342TotalAmt
Program Services$3,959ProgramServicesAmt
Management And General$5,383ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,674,950TotalAmt
Program Services$1,669,567ProgramServicesAmt
Management And General$5,383ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$747,486BOYAmt
EOY$720,880EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$48,102BOYAmt
EOY$10,917EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$10,417EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,231BOYAmt
EOY$2,567EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$481,465LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$416,557LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$89,658BOYAmt
EOY$64,908EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$32,941BOYAmt
EOY$37,191EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$80,199BOYAmt
EOY$295,724EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,000,617BOYAmt
EOY$1,142,604EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$185,181BOYAmt
EOY$163,461EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$208,583EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$185,181BOYAmt
EOY$372,044EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$688,244BOYAmt
EOY$588,537EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$127,192BOYAmt
EOY$182,023EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$815,436BOYAmt
EOY$770,560EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,000,617BOYAmt
EOY$1,142,604EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$53,758ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$8,882NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,473,957CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,307,158CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,471,852CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,281,413CurrentTaxYearMinus1YearAmt
Current Tax Year$1,541,114CurrentTaxYearAmt
Total$8,075,494TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,473,957CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,307,158CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,471,852CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,281,413CurrentTaxYearMinus1YearAmt
Current Tax Year$1,541,114CurrentTaxYearAmt
Total$8,075,494TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$8,075,494PublicSupportTotal170Amt
Total Support$8,075,494TotalSupportAmt
Gross Receipts Rltd Activities$258,945GrossReceiptsRltdActivitiesAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$80,199BeginningYearBalanceAmt
Investment Earnings Or Losses$6,942InvestmentEarningsOrLossesAmt
End Year Balance$87,141EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$73,954BeginningYearBalanceAmt
Investment Earnings Or Losses$6,244InvestmentEarningsOrLossesAmt
End Year Balance$80,199EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$87,293BeginningYearBalanceAmt
Investment Earnings Or Losses-$13,339InvestmentEarningsOrLossesAmt
End Year Balance$73,954EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$70,822BeginningYearBalanceAmt
Investment Earnings Or Losses$16,471InvestmentEarningsOrLossesAmt
End Year Balance$87,293EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$67,412BeginningYearBalanceAmt
Investment Earnings Or Losses$3,410InvestmentEarningsOrLossesAmt
End Year Balance$70,822EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$70,993OtherCostOrOtherBasisAmt
Depreciation$29,784DepreciationAmt
Book Value$41,209BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$408,861OtherCostOrOtherBasisAmt
Depreciation$386,469DepreciationAmt
Book Value$22,392BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,611OtherCostOrOtherBasisAmt
Depreciation$304DepreciationAmt
Book Value$1,307BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$64,908TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
RIGHT OF USE ASSET$208,583
BENEFICIAL INTEREST - DENTAL FUND$87,141
FieldValueIRS element (for citing)
Total Book Value Other Assets$295,724TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLEASE LIABILITYDesc
Amt$208,583Amt
FieldValueIRS element (for citing)
Total Liability$208,583TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4FormAndLineReferenceDesc
ExplanationTHE PRINCIPAL VALUE OF THE ENDOWMENT FUND IS TO BE PERMANENTLY RESTRICTED, THE ANNUAL NET INCOME AND ACCUMULATED INCOME FROM PRIOR YEARS IS AVAILABLE FOR USE IN DENTISTRY WITH THE APPROPRIATE APPROVALS.ExplanationTxt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$977,327NoncashContributionsRptF990Amt
Method Of Determining RevenuesWHOLESALE VALUEMethodOfDeterminingRevenuesTxt
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 (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS DISTRIBUTED TO THE GOVERNING BOARD VIA EMAIL FOR REVIEW BEFORE FILING.
FORM 990, PAGE 6, PART VI, LINE 15ATHE GOVERNING BODY REVIEWS AND APPROVES EXECUTIVE DIRECTOR'S COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS ARE KEPT AT ADMINISTRATIVE OFFICE OF EBENEZER MEDICAL OUTREACH, INC. AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS CENTRE LIMITED PARTNERSHIPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
EIN550784814EIN
Primary ActivitiesREAL EST.PrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$160,360ShareOfTotalIncomeAmt
Share Of EOY Assets$594,985ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EMOS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
EIN562387395EIN
Primary ActivitiesLEASE BLDGPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeC CORPEntityTypeTxt
Ownership1.00000OwnershipPct
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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