ETHNE HEALTH: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: ETHNE HEALTH (EIN 82-3920554)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2020-11-19
IRS object ID: 202013249349300711
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-19T07:58:45-06:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	842562320	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ALTRUIS CPAS LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	180 INTERSTATE NORTH PARKWAY SE STE	AddressLine1Txt
Address Line2	205	AddressLine2Txt
City	ATLANTA	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30339	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	823920554	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ETHNE HEALTH INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ETHN	BusinessNameControlTxt
Phone	4707990044	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4122 E PONCE DE LEON AVENUE NO 5	AddressLine1Txt
City	CLARKSTON	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30021	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ANDREW KIM	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4707990044	PhoneNum
Signature	2020-11-17	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JOSH ROPER CPA	PreparerPersonNm
PTIN	P00962518	PTIN
Phone	7709528544	PhoneNum

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	ANDREW KIM	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4122 E PONCE DE LEON AVE 5	AddressLine1Txt
City	CLARKSTON	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30021	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,001,341	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.ETHNEHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2017	FormationYr
Legal Domicile State	GA	LegalDomicileStateCd
Activity Or Mission	ETHNE HEALTH DELIVERS COMPREHENSIVE, HIGH VALUE HEALTHCARE THROUGH A CULTURALLY SENSITIVE, NEIGHBOR-CENTERED MEDICAL HOME. WE OFFER PRIMARY CARE (FOR BOTH ADULTS AND KIDS), ACUTE CARE, PSYCHIATRY, EARLY OBSTETRICS, GYNECOLOGY, AND HIV CARE. WE SERVE EVERYONE, REGARDLESS OF INSURANCE OR ABILITY TO PAY.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$272,071	PYContributionsGrantsAmt
CY Contributions Grants	$546,266	CYContributionsGrantsAmt
PY Program Service Revenue	$115,189	PYProgramServiceRevenueAmt
CY Program Service Revenue	$455,075	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$387,260	PYTotalRevenueAmt
CY Total Revenue	$1,001,341	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$19,335	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$135,458	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$9,098	CYTotalFundraisingExpenseAmt
PY Other Expenses	$142,044	PYOtherExpensesAmt
CY Other Expenses	$450,074	CYOtherExpensesAmt
PY Total Expenses	$161,379	PYTotalExpensesAmt
CY Total Expenses	$585,532	CYTotalExpensesAmt
PY Revenues Less Expenses	$225,881	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$415,809	CYRevenuesLessExpensesAmt
Total Assets BOY	$272,012	TotalAssetsBOYAmt
Total Assets EOY	$710,110	TotalAssetsEOYAmt
Total Liabilities BOY	$3,018	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$25,307	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$268,994	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$684,803	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	ETHNE HEALTH DELIVERS COMPREHENSIVE, HIGH VALUE HEALTHCARE THROUGH A CULTURALLY SENSITIVE, NEIGHBOR-CENTERED MEDICAL HOME. WE OFFER PRIMARY CARE (FOR BOTH ADULTS AND KIDS), ACUTE CARE, PSYCHIATRY, EARLY OBSTETRICS, GYNECOLOGY, AND HIV CARE. WE SERVE EVERYONE, REGARDLESS OF INSURANCE OR ABILITY TO PAY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$549,971	ExpenseAmt
Revenue	$455,075	RevenueAmt
Desc	ETHNE HEALTH ONLY HAS ONE PROGRAM, WHICH IS RUNNING THE CLINIC.	Desc
Total Program Service Expenses	$549,971	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ANDREW KIM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4707990044	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4122 E PONCE DE LEON AVENUE SUITE 5	AddressLine1Txt
City	CLARKSTON	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30021	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
BILL MURRAY
CHAIRMAN	2.00	Yes (X)	Yes (X)	$0	$0	$0
LAURIE BODEN
VICE CHAIRMAN	8.00	Yes (X)	Yes (X)	$0	$0	$0
ANDREW KIM
TREASURER	25.00	Yes (X)	Yes (X)	$0	$0	$0
KATE LINDSEY
DIRECTOR	10.00	Yes (X)		$0	$0	$0
RICK BODEN
DIRECTOR	2.00	Yes (X)		$0	$0	$0
ROBERT CAMPBELL
DIRECTOR	1.00	Yes (X)		$0	$0	$0
SEAN LINDSEY
DIRECTOR	25.00	Yes (X)		$0	$0	$0
SARAH NEELY
DIRECTOR	8.00	Yes (X)		$0	$0	$0
DANIEL ZAGAMI
DIRECTOR	2.00	Yes (X)		$0	$0	$0
RONALD BAUM
DIRECTOR	2.00	Yes (X)		$0	$0	$0
DARARA GUBO
DIRECTOR	2.00	Yes (X)		$0	$0	$0
ABENA KORAM
DIRECTOR	2.00	Yes (X)		$0	$0	$0
ROBBIE CONTINO
CEO	25.00	Yes (X)	Yes (X)	$0	$0	$0
KACIE MCDONNELL
DIRECTOR	2.00	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$546,266	AllOtherContributionsAmt
Total Contributions	$546,266	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	MEDICAL SERVICE FEES	Desc
Business	621300	BusinessCd
Total Revenue Column	$455,075	TotalRevenueColumnAmt
Related Or Exempt Func Income	$455,075	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$455,075	TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,001,341	TotalRevenueColumnAmt
Related Or Exempt Func Income	$455,075	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$123,913	TotalAmt
Program Services	$123,913	ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$11,545	TotalAmt
Program Services	$11,545	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$4,500	TotalAmt
Management And General	$4,500	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$280,187	TotalAmt
Program Services	$277,387	ProgramServicesAmt
Management And General	$2,800	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$10,284	TotalAmt
Management And General	$1,186	ManagementAndGeneralAmt
Fundraising	$9,098	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$10,520	TotalAmt
Management And General	$10,520	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$31,800	TotalAmt
Program Services	$31,800	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,673	TotalAmt
Management And General	$4,673	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$16,587	TotalAmt
Program Services	$15,625	ProgramServicesAmt
Management And General	$962	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
SUPPLIES	$40,143	$40,143
LAB FEES	$29,629	$29,629
UTILITIES	$16,574	$16,574
FACILITY & EQUIPMENT RE	$2,965	$2,965

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,212	TotalAmt
Program Services	$390	ProgramServicesAmt
Management And General	$1,822	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$585,532	TotalAmt
Program Services	$549,971	ProgramServicesAmt
Management And General	$26,463	ManagementAndGeneralAmt
Fundraising	$9,098	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$238,117	BOYAmt
EOY	$609,533	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$11,462	BOYAmt
EOY	$76,879	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$25,766	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$5,068	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$21,333	BOYAmt
EOY	$20,698	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,100	BOYAmt
EOY	$3,000	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$272,012	BOYAmt
EOY	$710,110	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$3,018	BOYAmt
EOY	$2,410	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$18,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$4,897	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,018	BOYAmt
EOY	$25,307	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	$206,007	BOYAmt
EOY	$574,803	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$62,987	BOYAmt
EOY	$110,000	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$268,994	BOYAmt
EOY	$684,803	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$272,012	BOYAmt
EOY	$710,110	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$415,809	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

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 D IRS990ScheduleD

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$25,766	InvestmentCostOrOtherBasisAmt
Depreciation	$5,068	DepreciationAmt
Book Value	$20,698	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$20,698	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ACCRUED EXPENSES	Desc
Amt	$4,897	Amt

Field	Value	IRS element (for citing)
Total Liability	$4,897	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	NO UNCERTAIN TAX POSITIONS NOTED.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	NONE NOTED.
FORM 990, PART VI, SECTION C, LINE 19	AVAILABLE AT REQUEST.
FORM 990, PART IX, LINE 11G	MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 277,387. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 277,387. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,800.