PEDIPLACE: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PEDIPLACE (EIN 75-2512752)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-06-16
- IRS object ID
- 202211679349300916
- 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 | 2022-06-16T09:15:14-07:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 752593210 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sutton Frost Cary LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Six Flags Dr Suite 600 | AddressLine1Txt |
| City | Arlington | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752512752 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIPLACE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEDI | BusinessNameControlTxt |
| Phone | 9724367962 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 S OLD ORCHARD 126 | AddressLine1Txt |
| City | LEWISVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75067 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LARRY ROBINS | PersonNm |
| Person Title | President & CEO | PersonTitleTxt |
| Signature | 2022-06-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LARRY | PersonFirstNm |
| Person Last | ROBINS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Carroll Elizabeth Arnott | PreparerPersonNm |
| PTIN | P01965628 | PTIN |
| Phone | 8176498083 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LARRY ROBINS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 S OLD ORCHARD 126 | AddressLine1Txt |
| City | LEWISVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75067 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,666,341 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pediplace.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL SERVICES TO UNINSURED AND UNDER-INSURED CHILDREN LIVING IN NORTH TEXAS. OUR MISSION IS TO MAKE HEALTHCARE A REALITY FOR EVERY KID. | ActivityOrMissionDesc |
| Voting Members Governing Body | 25 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 25 | VotingMembersIndependentCnt |
| Total Employee | 40 | TotalEmployeeCnt |
| Total Volunteers | 478 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,622,791 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,582,912 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,037,620 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,069,409 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,505 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,062 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$8,892 | PYOtherRevenueAmt |
| CY Other Revenue | -$10,930 | CYOtherRevenueAmt |
| PY Total Revenue | $4,654,024 | PYTotalRevenueAmt |
| CY Total Revenue | $4,644,453 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,721,451 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,854,935 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $15,600 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $15,750 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $276,720 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,371,639 | PYOtherExpensesAmt |
| CY Other Expenses | $1,915,723 | CYOtherExpensesAmt |
| PY Total Expenses | $4,108,690 | PYTotalExpensesAmt |
| CY Total Expenses | $3,786,408 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $545,334 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $858,045 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,960,192 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,701,486 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $261,203 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $144,452 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,698,989 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,557,034 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE MEDICAL SERVICES TO UNINSURED AND UNDER-INSURED CHILDREN LIVING IN NORTH TEXAS. OUR MISSION IS TO MAKE HEALTHCARE A REALITY FOR EVERY KID. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,263,879 | ExpenseAmt |
| Revenue | $1,069,409 | RevenueAmt |
| Desc | PEDIPLACE PROVIDED PRIMARY PEDIATRIC MEDICAL SERVICES TO MORE THAN 5,700 UNINSURED AND UNDER-INSURED CHILDREN LIVING THROUGHOUT NORTH TEXAS. | Desc |
| Total Program Service Expenses | $3,263,879 | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | 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 | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 40 | 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 |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 25 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 25 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LARRY ROBINS | PersonNm |
| Phone | 9724367962 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 S OLD ORCHARD 126 | AddressLine1Txt |
| City | LEWISVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75067 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| LARRY ROBINS | |||||||
| President & CEO | 50.00 | 0.00 | Yes (X) | $232,832 | $0 | $4,552 | |
| CASSANDRA SINGLETON | |||||||
| DIRECTOR OF CLINIC | 40.00 | 0.00 | $133,920 | $0 | $2,745 | ||
| KATHLEEN MCHUGH | |||||||
| NURSE PRACTINIONER | 40.00 | 0.00 | $116,934 | $0 | $2,373 | ||
| SANDRA RODRIGUEZ | |||||||
| NURSE PRACTIONER | 40.00 | 0.00 | $107,181 | $0 | $1,993 | ||
| JEFF BRANNEN | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| TERRY ALLEN | |||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SPENCER TURNER FACHE | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| RYAN SCHROER | |||||||
| IMM PAST CHAIR. | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| R VON BEOUGHER PE | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| NANI ISWARA | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| TOM AUGUSTINE | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| ARICIO BLASKO | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| CARL MENCKHOFF MD | |||||||
| Chairman | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SHAWN BLACK | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| DAVID FRAZIER | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JACK PHILLIPS | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JOHN MARTIN | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| SESHU RAO | |||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JAMES KERBOW | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JAMIE WILSON ED D | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| DONALD LYLES | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JANA PARROTT CHAMBERLAIN | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| TRISHA SHEFFIELD | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| PATRICIA GONZALEZ | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| KEVIN ROGERS ED D | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| SCOTT HURST | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| PAM SPOONER | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| KALPANA KELKAR MD FAAP | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| DAMITA WILLIAMS EDD RN | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $590,867 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $11,663 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEDICAL ASSOCIATES | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 265 | AddressLine1Txt |
| City | ARGYLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL PERSONNEL | ServicesDesc |
| Compensation | $177,595 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $250,000 | FederatedCampaignsAmt |
| Fundraising | $153,973 | FundraisingAmt |
| Government Grants | $1,471,384 | GovernmentGrantsAmt |
| All Other Contributions | $1,707,555 | AllOtherContributionsAmt |
| Noncash Contributions | $974,371 | NoncashContributionsAmt |
| Total Contributions | $3,582,912 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL SERVICES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,069,409 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,069,409 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,069,409 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,062 | TotalRevenueColumnAmt |
| Exclusion | $3,062 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $10,958 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $153,973 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $21,888 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,930 | TotalRevenueColumnAmt |
| Exclusion | -$10,930 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,644,453 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,069,409 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$7,868 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,384 | TotalAmt |
| Program Services | $60,201 | ProgramServicesAmt |
| Management And General | $82,422 | ManagementAndGeneralAmt |
| Fundraising | $94,761 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,398,424 | TotalAmt |
| Program Services | $1,266,765 | ProgramServicesAmt |
| Management And General | $29,978 | ManagementAndGeneralAmt |
| Fundraising | $101,681 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,077 | TotalAmt |
| Program Services | $9,077 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,249 | TotalAmt |
| Program Services | $76,553 | ProgramServicesAmt |
| Management And General | $6,440 | ManagementAndGeneralAmt |
| Fundraising | $11,256 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,801 | TotalAmt |
| Program Services | $94,058 | ProgramServicesAmt |
| Management And General | $7,913 | ManagementAndGeneralAmt |
| Fundraising | $13,830 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,050 | TotalAmt |
| Program Services | $2,025 | ProgramServicesAmt |
| Management And General | $2,025 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,150 | TotalAmt |
| Program Services | $7,575 | ProgramServicesAmt |
| Management And General | $7,575 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,750 | TotalAmt |
| Fundraising | $15,750 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $329,688 | TotalAmt |
| Program Services | $290,226 | ProgramServicesAmt |
| Management And General | $34,324 | ManagementAndGeneralAmt |
| Fundraising | $5,138 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,738 | TotalAmt |
| Program Services | $1,369 | ProgramServicesAmt |
| Fundraising | $1,369 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,667 | TotalAmt |
| Program Services | $4,445 | ProgramServicesAmt |
| Management And General | $2,985 | ManagementAndGeneralAmt |
| Fundraising | $237 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,220 | TotalAmt |
| Program Services | $35,110 | ProgramServicesAmt |
| Management And General | $35,110 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,174 | TotalAmt |
| Program Services | $149,145 | ProgramServicesAmt |
| Management And General | $7,606 | ManagementAndGeneralAmt |
| Fundraising | $15,423 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,101 | TotalAmt |
| Program Services | $3,682 | ProgramServicesAmt |
| Management And General | $5,214 | ManagementAndGeneralAmt |
| Fundraising | $4,205 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,721 | TotalAmt |
| Program Services | $95,721 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,685 | TotalAmt |
| Program Services | $27,773 | ProgramServicesAmt |
| Management And General | $3,372 | ManagementAndGeneralAmt |
| Fundraising | $540 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| IN-KIND PATIENT CARE COSTS | $974,371 | $974,371 | ||
| PATIENT CARE COSTS | $67,245 | $67,245 | ||
| SOFTWARE/LICENSING | $63,173 | $52,415 | $6,937 | $3,821 |
| HUMAN RESOURCES | $20,466 | $17,523 | $1,724 | $1,219 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,274 | TotalAmt |
| Program Services | $28,600 | ProgramServicesAmt |
| Management And General | $12,184 | ManagementAndGeneralAmt |
| Fundraising | $7,490 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,786,408 | TotalAmt |
| Program Services | $3,263,879 | ProgramServicesAmt |
| Management And General | $245,809 | ManagementAndGeneralAmt |
| Fundraising | $276,720 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,900 | BOYAmt |
| EOY | $523,880 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,459,956 | BOYAmt |
| EOY | $1,741,468 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,911 | BOYAmt |
| EOY | $265,846 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,159 | BOYAmt |
| EOY | $67,101 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $901,390 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $802,821 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,644 | BOYAmt |
| EOY | $98,569 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,622 | BOYAmt |
| EOY | $4,622 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,960,192 | BOYAmt |
| EOY | $2,701,486 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,090 | BOYAmt |
| EOY | $84,162 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,213 | BOYAmt |
| EOY | $60,290 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,900 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,203 | BOYAmt |
| EOY | $144,452 | 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 | $1,470,056 | BOYAmt |
| EOY | $2,432,034 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $228,933 | BOYAmt |
| EOY | $125,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,698,989 | BOYAmt |
| EOY | $2,557,034 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,960,192 | BOYAmt |
| EOY | $2,701,486 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $858,045 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,757,095 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,343,410 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,463,393 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,622,791 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,582,912 | CurrentTaxYearAmt |
| Total | $13,769,601 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,421,874 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,452,960 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,297,725 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,037,620 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,069,409 | CurrentTaxYearAmt |
| Total | $6,279,588 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,178,969 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,796,370 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,761,118 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,660,411 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,652,321 | CurrentTaxYearAmt |
| Total | $20,049,189 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $20,049,189 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,253 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,924 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,384 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,505 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,062 | CurrentTaxYearAmt |
| Total | $13,128 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,253 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,924 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,384 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,505 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,062 | CurrentTaxYearAmt |
| Total | $13,128 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $400 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$200 | CurrentTaxYearMinus3YearsAmt |
| Total | $200 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,182,622 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,798,094 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,763,502 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,662,916 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,655,383 | CurrentTaxYearAmt |
| Total | $20,062,517 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99930 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99930 | PublicSupportPY509Pct |
| Investment Income CY | 0.00070 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00070 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $352,759 | OtherCostOrOtherBasisAmt |
| Depreciation | $331,071 | DepreciationAmt |
| Book Value | $21,688 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,946 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,330 | DepreciationAmt |
| Book Value | $10,616 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $515,685 | OtherCostOrOtherBasisAmt |
| Depreciation | $449,420 | DepreciationAmt |
| Book Value | $66,265 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $98,569 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,684,172 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $39,719 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $39,719 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,644,453 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $4,644,453 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,826,127 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $39,719 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $39,719 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,786,408 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $3,786,408 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | PediPlace is exempt from federal income taxes under section 501(c)(3) of the Internal Revenue Code (IRC) and has not been classified as a private foundation as defined in the IRC. Income generated from activities unrelated to PediPlaces exempt purposes is subject to tax under IRC Section 511. PediPlace had no unrelated business income for the year ended December 31, 2021. Accordingly, no provision has been made for federal income tax. GAAP requires the evaluation of tax positions taken in the course of preparing PediPlaces tax returns and recognition of a tax liability (or asset) if PediPlace has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has analyzed the tax positions taken by PediPlace, and has concluded that as of December 31, 2021, there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | N TEXAS NP RESOURCES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10450 COUNTESS DR | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75229 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | GRANT WRITER | ActivityTxt |
| Fundraiser Control Of Funds | false | FundraiserControlOfFundsInd |
| Gross Receipts | $156,500 | GrossReceiptsAmt |
| Retained By Contractor | $15,750 | RetainedByContractorAmt |
| Net To Organization | $140,750 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $156,500 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $15,750 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $140,750 | TotalNetToOrganizationAmt |
| Licensed States | TX | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | RACE 2021 | Event1Nm |
| Gross Receipts Event1 | $139,901 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $135,434 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $4,467 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $200 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $4,467 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,300 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $4,611 | OtherDirectExpensesEvent1Amt |
| Event2 | POKER PARTY | Event2Nm |
| Gross Receipts Event2 | $25,030 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $18,539 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $6,491 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $2,750 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $1,100 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $3,740 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $3,500 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $220 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $164,931 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $153,973 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $10,958 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,750 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,300 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,207 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $4,800 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,831 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,888 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$10,930 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LARRY ROBINS | PersonNm |
| Title | President & CEO | TitleTxt |
| Base Compensation Filing Org | $191,814 | BaseCompensationFilingOrgAmt |
| Bonus Filing Organization | $32,618 | BonusFilingOrganizationAmount |
| Other Compensation Filing Org | $8,400 | OtherCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $4,552 | DeferredCompensationFlngOrgAmt |
| Total Compensation Filing Org | $237,384 | TotalCompensationFilingOrgAmt |
Schedule M IRS990ScheduleM
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $7,200 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $33,614 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 16153 | ContributionCnt |
| Noncash Contributions Rpt F990 | $933,557 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 2: New Services | PediPlace began providing mental health therapy services to established patients referred for service internally by a pediplace provider. Therapy services are provided by a Licensed Professional Counselor based on an MOU agreement with Jewish Family Services of Dallas. |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Terry Allen, Board Treasurer, is an employee of Frost Bank where PediPlace maintains a deposit account. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | AFTER THE PREPARATION OF AND BEFORE FILING THE 990, A PREPARER COPY IS SUBMITTED TO THE FINANCE COMMITTEE FOR REVIEW AND APPROVAL. ONCE FILED, THE ORGANIZATON IS PROVIDED A PUBLIC INSPECTION COPY FOR THEIR FILES. NEW BOARD MEMBERS RECEIVE A COPY OF FORM 990 FOR THE PERIOD LAST PREPARED AT THE BEGINNING OF THEIR BOARD SERVICE. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | THE TONE FOR A HIGH LEVEL OF ETHICS IS SET AT THE TOP. THE BOARD OF DIRECTORS IMPARTS ITS EXPECTATIONS TO ALL LEVELS OF MANAGEMENT. IN CONNECTION THEREWITH, ALL BOARD MEMBERS, MEMBERS OF COMMITTEES WHO ARE NOT BOARD MEMBERS, OFFICERS, AND EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST STATEMENT. THE SIGNED STATEMENTS ARE REVIEWED AND THE ACCOUNTING DEPARTMENT IS ADVISED OF ANY DISCLOSED CONFLICTS. ANY INDIVIDUAL WITH A POSSIBLE CONFLICT, OR WHO PERCEIVES OR RECOGNIZES A CONFLICT OF OTHERS, IS ENCOURAGED TO DISCUSS THE MATTER WITH THEIR IMMEDIATE SUPERVISOR. ALL CONFLICTS ARE ULTIMATELY DISCUSSED WITH THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | THE PRESIDENT/CEO'S COMPENSATION IS REVISED ANNUALLY BY A COMMITTEE APPOINTED BY THE BOARD CHAIR. BASE SALARY IS COMPARED WITH SIMILAR NOT-FOR-PROFITS AND FOR-PROFIT ORGANIZATIONS. STAFF SIZE, ANNUAL BUDGET, MARKET TRENDS AND SKILL LEVEL ARE USED TO DETERMINE COMPARABLE SALARIES IN THE HEALTHCARE INDUSTRY. BENCHMARK INFORMATION FROM OTHER EMPLOYERS AND SUMMARY DATA COMPILED FROM NOT-FOR-PROFIT ENTITY SURVEYS PRESENTED BI-ANNUALLY BY THE COMMUNITY COUNCIL OF GREATER DALLAS AND GUIDE STAR'S ANNUAL COMPENSATION REPORT ARE CONSULTED. ANNUAL PERFORMANCE MEASUREMENTS ARE ESTABLISHED TO EVALUATE BONUS GUIDELINES. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | OTHER OFFICERS ARE UNPAID. KEY EMPLOYEE COMPENSATION IS DETERMINED BY THE PRESIDENT AND CEO IN CONSULTATION WITH MEMBERS OF THE BOARD OF DIRECTORS. SALARIES ARE COMPARED WITH SIMILAR NOT-FOR-PROFIT AND FOR-PROFIT ORGANIZATIONS. STAFF SIZE, ANNUAL BUDGET, MARKET TRENDS AND SKILL LEVEL ARE USED TO DETERMINE COMPARABLE SALARIES IN THE HEALTHCARE INDUSTRY. BENCHMARK INFORMATION FROM OTHER EMPLOYERS, AND SUMMARY DATA COMPILED FROM NOT-FOR-PROFIT ENTITY SURVEYS PRESENTED BI-ANNUALLY BY THE COMMUNITY COUNCIL OF GREATER DALLAS BIENNIAL COMPENSATION REPORT ARE CONSULTED. ANNUAL PERFORMANCE MEASUREMENTS ARE ESTABLISHED TO EVALUATE BONUS GUIDELINES. ANNUAL PERFORMANCE EVALUATIONS ARE CONDUCTED TO DETERMINE MERIT INCREASES. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | COPIES OF GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. PEDIPLACE WILL PERIODICALLY UPLOAD THESE DOCUMENTS TO GUIDESTAR.COM AS PART OF OUR ORGANIZATION'S PROFILE. |
| FORM 990, PART VIII INCOME FROM FUNDRAISING EVENTS | THE NET ECONOMIC BENEFIT FROM OUR FUNDRAISING EVENT IS CALCULATED AS FOLLOWS:CONTRIBUTIONS FROM FUNDRAISING EVENT REPORTED ON PART VIII, LINE 1C $ 153,973GROSS INCOME FROM FUNDRAISING EVENT REPORT ON PART VIII, LINE 8A 10,958LESS: DIRECT COSTS OF EVENT REPORTED ON PART VIII, LINE 8B (21,888) NET ECONOMIC BENEFIT OF FUNDRAISING EVENTS $ 143,043 |
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