EBENZER MEDICAL OUTREACH INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- EBENZER MEDICAL OUTREACH INC (EIN 55-0745033)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202301359349301705
- Schema version
- 2021v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-15T08:25:31-04:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550657218 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HESS STEWART & CAMPBELL PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 940 4TH AVE STE 250 | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 257011455 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550745033 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EBENEZER MEDICAL OUTREACH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EBEN | BusinessNameControlTxt |
| Phone | 3045290753 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATT CHRISTIANSEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3045290753 | PhoneNum |
| Signature | 2023-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MATT | PersonFirstNm |
| Person Last | CHRISTIANSEN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHARLES M MORRIS | PreparerPersonNm |
| PTIN | P01354970 | PTIN |
| Phone | 3045236464 | PhoneNum |
| Preparation | 2023-05-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MATT CHRISTIANSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,543,379 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EMOHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE MEDICAL SERVICES TO THE UNINSURED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 17 | TotalEmployeeCnt |
| Total Volunteers | 36 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,307,158 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,471,852 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,507 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $65,608 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,546 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,438 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,751 | PYOtherRevenueAmt |
| CY Other Revenue | $2,481 | CYOtherRevenueAmt |
| PY Total Revenue | $1,346,962 | PYTotalRevenueAmt |
| CY Total Revenue | $1,543,379 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $303,644 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $317,327 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $988 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,046,008 | PYOtherExpensesAmt |
| CY Other Expenses | $1,168,378 | CYOtherExpensesAmt |
| PY Total Expenses | $1,349,652 | PYTotalExpensesAmt |
| CY Total Expenses | $1,485,705 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,690 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $57,674 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,137,328 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,160,409 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $206,469 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $194,278 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $930,859 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $966,131 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE MEDICAL SERVICES TO THE UNINSURED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,483,692 | ExpenseAmt |
| Revenue | $65,608 | RevenueAmt |
| Desc | PROVIDES 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 | $1,483,692 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 17 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REBECCA GLASS | PersonNm |
| Phone | 3045290753 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25701 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|
| REBECCA GLASS | ||||||
| ADMINISTRATO | 40.00 | Yes (X) | $49,101 | $0 | $0 | |
| AARON BLEVINS | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| MATT CHRISTIANSEN | ||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| FRAN D'EGIDIO | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| SARAH DENMAN | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| DAVID ELLER | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| STEPHANIE HOLMAN | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| RAJ KHANNA | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| DEB KOESTER | ||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DENISE LANDRY | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| LISA MARTIN | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| SUE MCCLELLAND | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| KATHLEEN NAPIER | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| STEPHEN PETRANY | ||||||
| VICE PRESIDE | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CHRISTOPHER PLYBON | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| DERON RUNYON | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LEONARD WHITE | ||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |
| W BRENT STURM | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $49,101 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $347,099 | GovernmentGrantsAmt |
| All Other Contributions | $1,124,753 | AllOtherContributionsAmt |
| Noncash Contributions | $821,530 | NoncashContributionsAmt |
| Total Contributions | $1,471,852 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BILLINGS | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $65,608 | TotalRevenueColumnAmt |
| Exclusion | $65,608 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $65,608 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,438 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,438 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $1,243 | FundraisingGrossIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,243 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,238 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,238 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,238 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,543,379 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,676 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $65,608 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,101 | TotalAmt |
| Program Services | $49,101 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,097 | TotalAmt |
| Program Services | $243,097 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,129 | TotalAmt |
| Program Services | $25,129 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,920 | TotalAmt |
| Program Services | $12,920 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,651 | TotalAmt |
| Program Services | $24,651 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,851 | TotalAmt |
| Program Services | $95,851 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416 | TotalAmt |
| Program Services | $416 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,936 | TotalAmt |
| Program Services | $3,936 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,786 | TotalAmt |
| Program Services | $24,786 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,588 | TotalAmt |
| Program Services | $6,588 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| CONTRIBUTED SUPPLIES & EQ | $821,530 | $821,530 |
| OTHER PROFESSIONAL SERVIC | $119,543 | $119,543 |
| SUPPLIES | $35,448 | $35,448 |
| EQUIPMENT RENTAL/PURCHASE | $13,081 | $13,081 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,628 | TotalAmt |
| Program Services | $7,615 | ProgramServicesAmt |
| Management And General | $1,025 | ManagementAndGeneralAmt |
| Fundraising | $988 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,485,705 | TotalAmt |
| Program Services | $1,483,692 | ProgramServicesAmt |
| Management And General | $1,025 | ManagementAndGeneralAmt |
| Fundraising | $988 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $762,474 | BOYAmt |
| EOY | $803,723 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,625 | BOYAmt |
| EOY | $142,942 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,630 | BOYAmt |
| EOY | $4,960 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $472,555 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $366,555 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,454 | BOYAmt |
| EOY | $106,000 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,852 | BOYAmt |
| EOY | $28,830 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,293 | BOYAmt |
| EOY | $73,954 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,137,328 | BOYAmt |
| EOY | $1,160,409 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,469 | BOYAmt |
| EOY | $194,278 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,469 | BOYAmt |
| EOY | $194,278 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $793,510 | BOYAmt |
| EOY | $809,611 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,349 | BOYAmt |
| EOY | $156,520 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $930,859 | BOYAmt |
| EOY | $966,131 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,137,328 | BOYAmt |
| EOY | $1,160,409 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $57,674 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$22,402 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,332,247 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,433,217 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,473,957 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,307,158 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,471,852 | CurrentTaxYearAmt |
| Total | $7,018,431 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,332,247 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,433,217 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,473,957 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,307,158 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,471,852 | CurrentTaxYearAmt |
| Total | $7,018,431 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $115,919 | SubstantialContributorsTotAmt |
| Public Support Total170 | $6,902,512 | PublicSupportTotal170Amt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,912 | CurrentTaxYearMinus4YearsAmt |
| Total | $9,912 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $7,028,343 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $219,330 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98210 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98050 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | 9,912 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $87,293 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$13,339 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $73,954 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $70,822 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $16,471 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $87,293 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $67,412 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,410 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $70,822 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $64,119 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,293 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $67,412 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $59,922 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,197 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $64,119 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,993 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,806 | DepreciationAmt |
| Book Value | $49,187 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $401,562 | OtherCostOrOtherBasisAmt |
| Depreciation | $344,749 | DepreciationAmt |
| Book Value | $56,813 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $106,000 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFICIAL INTEREST - DENTAL FUND | Desc |
| Book Value | $73,954 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $73,954 | TotalBookValueOtherAssetsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 2, PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | THE PRINCIPAL VALUE OF THE ENDOWMWNR 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $821,530 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | WHOLESALE VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS DISTRIBUTED TO THE GOVERNING BOARD VIA EMAIL FOR REVIEW BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE GOVERNING BODY REVIEWS AND APPROVES EXECUTIVE DIRECTOR'S COMPENSATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLASS CENTRE LIMITED PARTNERSHIP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550784814 | EIN |
| Primary Activities | REAL EST. | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $657,192 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $199,307 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMOS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562387395 | EIN |
| Primary Activities | LEASE BLDG | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C CORP | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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