GRACE VILLAGE MEDICAL CLINIC INC: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GRACE VILLAGE MEDICAL CLINIC INC (EIN 87-1210014)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202243189349200134
- 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 | 2022-11-14T08:23:53-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 871210014 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grace Village Medical Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Michael Sorrells | InCareOfNm |
| Business Name Control | GRAC | BusinessNameControlTxt |
| Foreign Phone | 4046637991 | ForeignPhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4002 East Ponce de Leon Ave | AddressLine1Txt |
| City | Clarkston | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30021 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Doug Cox | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2022-11-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Website Address | https: www.gracevillagemedicalclinic.org | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $59,738 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $59,738 | ContributionsGiftsGrantsEtcAmt |
| Gain Or Loss From Sale Of Assets | $0 | GainOrLossFromSaleOfAssetsAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Total Revenue | $59,738 | TotalRevenueAmt |
| Fees And Other Pymt To Ind Cntrct | $24,863 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $1,044 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $6,423 | OtherExpensesTotalAmt |
| Total Expenses | $32,330 | TotalExpensesAmt |
| Excess Or Deficit For Year | $27,408 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $16,856 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $44,264 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,856 | BOYAmt |
| EOY | $44,264 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,856 | BOYAmt |
| EOY | $44,264 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,856 | BOYAmt |
| EOY | $44,264 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | TheMissionofGraceVillageMedicalClinicistoprovidequality,wholistichealthcaretopeoplewhootherwisecouldnotaffordit. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| LabWorkGVMCprovidesfreehealthcareintheCityofClarkston,GAandthesurroundingcommunities.ClarkstonisoneofthelargestCityofRefugeintheU.S.RefugeesfromallovertheworldaregivenhaveninClarkston.LabworkisprovidedfreeofchargeandisusedbylicensedMedicalDoctorsandNursesintreatingpatients. | $7,500 | $16,166 |
| LicensedMedicalDoctorsandNursesprovideawiderangeofmedicalcareandservicesincludinglabworkandmedications.Visioncareisperiodicallyprovidedaswell. | $3,000 | $8,991 |
| ProvideawiderangeofWomen'sServicesandCareincludinglabworkandmedications. | $5,000 | $7,173 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $32,330 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (3 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| Michael Sorrells | ||
| CEO | 20.00 | $0 |
| Mike Hoffer | ||
| Secretary | 8.00 | $0 |
| Doug Cox | ||
| CFO | 2.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Doug Cox | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3061 Deanna Way Southwest | AddressLine1Txt |
| City | Lawrenceville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30044 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4046637991 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Doing Business As Names | Grace Village Medical Clinic |
| Part I, line 16 | | Other Expenses:, Amount:| Office Equipment and Supplies Medical Supplies Small Tools and Equipment And Internet Website and Phone Fees, $6423| |
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