EBENZER MEDICAL OUTREACH INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
EBENZER MEDICAL OUTREACH INC (EIN 55-0745033)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-11
IRS object ID
202101319349302395
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-11T16:20:17-04:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN204891915PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SullivanWebb PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1422 Kinetic Drive Suite CAddressLine1Txt
CityHuntingtonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550745033EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDERON RUNYONPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3046970565PhoneNum
Signature2021-05-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRUCE I SULLIVAN CPAPreparerPersonNm
PTINP00177743PTIN
Phone3046970565PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$1,538,212GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EMOHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionPROVIDE MEDICAL SERVICES TO THE UNINSUREDActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee13TotalEmployeeCnt
Total Volunteers37TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,433,217PYContributionsGrantsAmt
CY Contributions Grants$1,473,957CYContributionsGrantsAmt
PY Program Service Revenue$54,984PYProgramServiceRevenueAmt
CY Program Service Revenue$46,727CYProgramServiceRevenueAmt
PY Investment Income$2,398PYInvestmentIncomeAmt
CY Investment Income$1,376CYInvestmentIncomeAmt
PY Other Revenue$3,232PYOtherRevenueAmt
CY Other Revenue$16,152CYOtherRevenueAmt
PY Total Revenue$1,493,831PYTotalRevenueAmt
CY Total Revenue$1,538,212CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$233,111PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$268,220CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$300CYTotalFundraisingExpenseAmt
PY Other Expenses$1,037,459PYOtherExpensesAmt
CY Other Expenses$1,162,150CYOtherExpensesAmt
PY Total Expenses$1,270,570PYTotalExpensesAmt
CY Total Expenses$1,430,370CYTotalExpensesAmt
PY Revenues Less Expenses$223,261PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$107,842CYRevenuesLessExpensesAmt
Total Assets BOY$977,039TotalAssetsBOYAmt
Total Assets EOY$1,097,004TotalAssetsEOYAmt
Total Liabilities BOY$176,962TotalLiabilitiesBOYAmt
Total Liabilities EOY$186,195TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$800,077NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$910,809NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE MEDICAL SERVICES TO THE UNINSUREDMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,429,103ExpenseAmt
Revenue$46,727RevenueAmt
DescPROVIDES FREE MEDICAL CARE TO THE UNEMPLOYED AND WORKING POOR WHO ARE WITHOUT HEALTH INSURANCE AND ARE AT OR BELOW THE FEDERAL INCOME POVERTY GUIDELINES. SERVICES PROVIDED INCLUDE GENERAL MEDICINE, BREAST/CERVICAL CANCER SCREENINGS, COUNSELING, LAB AND MEDICINES.Desc
Total Program Service Expenses$1,429,103TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee13EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonREBECCA GLASSPersonNm
Phone3045290753PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MATT CHRISTIANSEN
PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
STEPHEN PETRANY
VICE PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
DEB KOESTER
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
DERON RUNYON
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
FRAN DEGIDIO
BOARD MEMBER1.000.00Yes (X)$0$0$0
RAJ KHANNA
BOARD MEMBER1.000.00Yes (X)$0$0$0
SARAH DENMAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
STEPHANIE HOLMAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
DOUG SHEILS
BOARD MEMBER1.000.00Yes (X)$0$0$0
LISA MARTIN
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHRISTOPHER PLYBON
BOARD MEMBER1.000.00Yes (X)$0$0$0
AARON BLEVINS
BOARD MEMBER1.000.00Yes (X)$0$0$0
DENISE LANDRY
BOARD MEMBER1.000.00Yes (X)$0$0$0
DAVID ELLER
BOARD MEMBER1.000.00Yes (X)$0$0$0
SUE McCLELLAND
BOARD MEMBER1.000.00Yes (X)$0$0$0
LEONARD WHITE
BOARD MEMBER1.000.00Yes (X)$0$0$0
REBECCA GLASS
ADMINISTRATOR0.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$5FundraisingAmt
Government Grants$420,532GovernmentGrantsAmt
All Other Contributions$1,053,420AllOtherContributionsAmt
Noncash Contributions$914,000NoncashContributionsAmt
Total Contributions$1,473,957TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescBILLINGSDesc
Business621400BusinessCd
Total Revenue Column$46,727TotalRevenueColumnAmt
Related Or Exempt Func Income$46,727RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$46,727TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,376TotalRevenueColumnAmt
Related Or Exempt Func Income$1,376RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Contri Rpt Fundraising Event$5ContriRptFundraisingEventAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$16,152TotalRevenueColumnAmt
Related Or Exempt Func Income$16,152RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$16,152OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,538,212TotalRevenueColumnAmt
Related Or Exempt Func Income$64,255RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$41,208TotalAmt
Program Services$41,208ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$204,787TotalAmt
Program Services$204,787ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$22,225TotalAmt
Program Services$22,225ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,118TotalAmt
Program Services$1,118ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$15,544TotalAmt
Program Services$15,544ProgramServicesAmt

Occupancy OccupancyGrp

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

Travel TravelGrp

FieldValueIRS element (for citing)
Total$16TotalAmt
Program Services$16ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,662TotalAmt
Program Services$2,662ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$25,485TotalAmt
Program Services$25,485ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,444TotalAmt
Program Services$4,444ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
CONTRIBUTED SUPPLIES AND EQ$914,000$914,000
PROFESSIONAL COSTS & OTHER$49,757$49,757
EQUIPMENT PURCHASERENTAL$13,220$13,220
SUPPLIES$31,214$31,214

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,839TotalAmt
Program Services$7,572ProgramServicesAmt
Management And General$967ManagementAndGeneralAmt
Fundraising$300FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,430,370TotalAmt
Program Services$1,429,103ProgramServicesAmt
Management And General$967ManagementAndGeneralAmt
Fundraising$300FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$632,430BOYAmt
EOY$683,953EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$88,985BOYAmt
EOY$133,254EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$19,203BOYAmt
EOY$46,473EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,731BOYAmt
EOY$4,410EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$448,254LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$316,545LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$133,501BOYAmt
EOY$131,709EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$25,777BOYAmt
EOY$26,383EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$67,412BOYAmt
EOY$70,822EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$977,039BOYAmt
EOY$1,097,004EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$176,962BOYAmt
EOY$186,195EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$176,962BOYAmt
EOY$186,195EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$670,966BOYAmt
EOY$796,787EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$129,111BOYAmt
EOY$114,022EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$800,077BOYAmt
EOY$910,809EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$977,039BOYAmt
EOY$1,097,004EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$107,842ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,890NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,240,739CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,143,515CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,332,247CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,433,217CurrentTaxYearMinus1YearAmt
Current Tax Year$1,473,957CurrentTaxYearAmt
Total$6,623,675TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,240,739CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,143,515CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,332,247CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,433,217CurrentTaxYearMinus1YearAmt
Current Tax Year$1,473,957CurrentTaxYearAmt
Total$6,623,675TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$112,742SubstantialContributorsTotAmt
Public Support Total170$6,510,933PublicSupportTotal170Amt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,907CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,050CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,912CurrentTaxYearMinus2YearsAmt
Total$31,869TotalAmt
FieldValueIRS element (for citing)
Total Support$6,655,544TotalSupportAmt
Gross Receipts Rltd Activities$330,158GrossReceiptsRltdActivitiesAmt
Public Support CY1700.97830PublicSupportCY170Pct
Public Support PY1700.97100PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$67,412BeginningYearBalanceAmt
Investment Earnings Or Losses$3,410InvestmentEarningsOrLossesAmt
End Year Balance$70,822EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,119BeginningYearBalanceAmt
Investment Earnings Or Losses$3,293InvestmentEarningsOrLossesAmt
End Year Balance$67,412EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,922BeginningYearBalanceAmt
Investment Earnings Or Losses$4,197InvestmentEarningsOrLossesAmt
End Year Balance$64,119EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,408BeginningYearBalanceAmt
Investment Earnings Or Losses$5,514InvestmentEarningsOrLossesAmt
End Year Balance$59,922EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,213BeginningYearBalanceAmt
Investment Earnings Or Losses$195InvestmentEarningsOrLossesAmt
End Year Balance$54,408EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$448,254InvestmentCostOrOtherBasisAmt
Depreciation$316,545DepreciationAmt
Book Value$131,709BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$131,709TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST-DENTAL FUNDDesc
Book Value$70,822BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$70,822TotalBookValueOtherAssetsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceEndowment funds intended uses (Part V, line 4)FormAndLineReferenceDesc
ExplanationTHE PRINCIPAL VALUE OF THE ENDOWMENT FUND IS TO BE PERMANENTLY RESTRICTED, THE ANNUAL NET INCOME AND ACCUMULATED INCOME FROM PRIOR YEARS IS AVAILABLE FOR USE IN DENTISTRY WITH THE APPROPRIATE APPROVALS.ExplanationTxt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$914,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesWHOLESALE VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11FORM 990 IS DISTRIBUTED TO THE GOVERNING BOARD VIA EMAIL FOR REVIEW BEFORE FILING.
CEO executive director top management comp Part VI line 15aTHE GOVERNING BODY REVIEWS AND APPROVES EXECUTIVE DIRECTORS COMPENSATION.
Governing documents etc available to public Part VI line 19GOVERNING DOCUMENTS ARE KEPT AT ADMINISTRATIVE OFFICE OF EBENEZER MEDICAL OUTREACH, INC. AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS CENTRE LPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
EIN550784814EIN
Primary ActivitiesREAL ESTATE HOLDINGPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$2,347ShareOfTotalIncomeAmt
Share Of EOY Assets$854,756ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EMOS INCBusinessNameLine1Txt

US Address USAddress

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

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