INDIAN FAMILY HEALTH CLINIC OF GREAT FALLS INC: Form 990, tax year 2018
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- Organization
- INDIAN FAMILY HEALTH CLINIC OF GREAT FALLS INC (EIN 81-0542869)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-14
- IRS object ID
- 202002279349302955
- Schema version
- 2018v3.2
- 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 | 2020-08-14T17:39:18-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 614 PARK DRIVE SOUTH | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810542869 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIAN FAMILY HEALTH CLINIC OF GREAT | BusinessNameLine1Txt |
| Business Name Line2 | FALLS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 4062681510 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1220 CENTRAL AVE | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WES OLD COYOTE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 4062681510 | PhoneNum |
| Signature | 2020-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARI YOUNG | PreparerPersonNm |
| PTIN | P01625181 | PTIN |
| Phone | 4067271798 | PhoneNum |
| Preparation | 2020-08-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 66.109.138.123 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-14 | IPDt |
| IP Tm | 10:06:02 | IPTm |
| IP Timezone | MD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9F7B664AEDA5BE1115C8F7C7188A6F21E70FD718 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3866012A22C74AB5E290245CA6ADB5C628B5E8B5 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WES OLD COYOTE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1220 CENTRAL AVE | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,810,830 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF HEALTH CLINIC FOR NATIVE AMERICANS RESIDING IN GREAT FALLS, MT AREA. THE CLINIC PROVIDES MEDICAL SERVICES, MENTAL HEALTH AND ALCOHOL COUNSELING, IMMUNIZATIONS, DIABETES COUNSELING AND COMMUNITY SERVICES. THE CLINIC IS ALSO OPEN TO NON-NATIVE AMERICANS IN NEED OF MEDICAL ASSISTANCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 16 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,301,856 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,587,124 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $176,305 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $155,994 | CYProgramServiceRevenueAmt |
| PY Investment Income | $380 | PYInvestmentIncomeAmt |
| CY Investment Income | $772 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $66,940 | CYOtherRevenueAmt |
| PY Total Revenue | $1,478,541 | PYTotalRevenueAmt |
| CY Total Revenue | $1,810,830 | 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 | $941,542 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $809,341 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $468,458 | PYOtherExpensesAmt |
| CY Other Expenses | $1,054,654 | CYOtherExpensesAmt |
| PY Total Expenses | $1,410,000 | PYTotalExpensesAmt |
| CY Total Expenses | $1,863,995 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $68,541 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$53,165 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,466,336 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,234,016 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $307,077 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $127,922 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,159,259 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,106,094 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OPERATION OF A CLINIC FOR NATIVE AMERICANS RESIDING IN THE GREAT FALLS, MT AREA. CLINIC PROVIDES MEDICAL SERVICES, MENTAL HEALTH AND ALCOHOL COUNSELING, IMMUNIZATIONS, DIABETES COUNSELING AND COMMUNITY SERVICES. CLINIC IS ALSO OPEN TO NON-NATIVE AMERICANS WHO ARE IN NEED OF MEDICAL ASSISTANCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,580,831 | ExpenseAmt |
| Revenue | $222,934 | RevenueAmt |
| Desc | PROVIDE MEDICAL SERVICES, MENTAL HEALTH AND ALCOHOL COUNSELING, IMMUNIZATIONS, DIABETES COUNSELING AND COMMUNITY SERVICES TO NATIVE AND NON-NATIVE AMERICANS IN NEED OF MEDICAL ASSISTANCE. | Desc |
| Total Program Service Expenses | $1,580,831 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 16 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WES OLD COYOTE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4062681510 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1220 CENTRAL AVE | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| DR WILLIAM MCGREGOR | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SHAWNA JARVEY | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CHERI KICKINGWOMAN | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KIM GAGNON | ||||||
| CHAIRMAN | 5.00 | $0 | $0 | $0 | Yes (X) | |
| WES OLD COYOTE | ||||||
| EXECUTIVE DIRECTOR | 40.00 | $115,141 | $0 | $0 | Yes (X) | |
| JOE | ||||||
| GERVAIS | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $115,141 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | A SCOTT DEVOUS | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1220 CENTRAL AVE | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL SERVICES | ServicesDesc |
| Compensation | $115,086 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,586,124 | GovernmentGrantsAmt |
| All Other Contributions | $1,000 | AllOtherContributionsAmt |
| Total Contributions | $1,587,124 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 624100 | $146,096 | $146,096 |
| GYM DIRECT PAY | 900099 | $9,898 | $9,898 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $155,994 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $772 | TotalRevenueColumnAmt |
| Exclusion | $772 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $66,940 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,940 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $66,940 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,810,830 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $222,934 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $772 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,141 | TotalAmt |
| Program Services | $113,268 | ProgramServicesAmt |
| Management And General | $1,873 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,435 | TotalAmt |
| Program Services | $530,660 | ProgramServicesAmt |
| Management And General | $8,775 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,348 | TotalAmt |
| Program Services | $7,348 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,016 | TotalAmt |
| Program Services | $90,016 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,401 | TotalAmt |
| Program Services | $56,014 | ProgramServicesAmt |
| Management And General | $1,387 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,419 | TotalAmt |
| Program Services | $15,099 | ProgramServicesAmt |
| Management And General | $2,320 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,295 | TotalAmt |
| Program Services | $20,048 | ProgramServicesAmt |
| Management And General | $2,247 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,217 | TotalAmt |
| Program Services | $453,257 | ProgramServicesAmt |
| Management And General | $70,960 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,904 | TotalAmt |
| Program Services | $8,356 | ProgramServicesAmt |
| Management And General | $548 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,974 | TotalAmt |
| Program Services | $10,214 | ProgramServicesAmt |
| Management And General | $2,760 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,162 | TotalAmt |
| Program Services | $31,152 | ProgramServicesAmt |
| Management And General | $129,010 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,896 | TotalAmt |
| Program Services | $86,616 | ProgramServicesAmt |
| Management And General | $1,280 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,408 | TotalAmt |
| Management And General | $36,408 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,889 | TotalAmt |
| Program Services | $5,934 | ProgramServicesAmt |
| Management And General | $3,955 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BEHAVIORAL/MENTAL HEALT | $60,993 | $60,893 | $100 |
| CLINIC | $46,638 | $45,879 | $759 |
| SMALL EQUIPMENT | $16,606 | $16,649 | -$43 |
| LABORATORY COST | $15,759 | $4,476 | $11,283 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,494 | TotalAmt |
| Program Services | $24,952 | ProgramServicesAmt |
| Management And General | $9,542 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,863,995 | TotalAmt |
| Program Services | $1,580,831 | ProgramServicesAmt |
| Management And General | $283,164 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $635,132 | BOYAmt |
| EOY | $353,972 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,387 | BOYAmt |
| EOY | $11,415 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,105 | BOYAmt |
| EOY | $119,126 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,331 | BOYAmt |
| EOY | $73,862 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,388 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,815 | BOYAmt |
| EOY | $21,517 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $881,986 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $232,250 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $666,956 | BOYAmt |
| EOY | $649,736 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,610 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,466,336 | BOYAmt |
| EOY | $1,234,016 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,510 | BOYAmt |
| EOY | $95,586 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,567 | BOYAmt |
| EOY | $32,336 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $307,077 | BOYAmt |
| EOY | $127,922 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,159,259 | BOYAmt |
| EOY | $1,106,094 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,159,259 | BOYAmt |
| EOY | $1,106,094 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,466,336 | BOYAmt |
| EOY | $1,234,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$53,165 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,077,876 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,104,391 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,809,551 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,301,856 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,587,124 | CurrentTaxYearAmt |
| Total | $6,880,798 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,077,876 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,104,391 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,809,551 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,301,856 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,587,124 | CurrentTaxYearAmt |
| Total | $6,880,798 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $6,880,798 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $39 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $44 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $74 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $380 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $772 | CurrentTaxYearAmt |
| Total | $1,309 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,579 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,005 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $66,940 | CurrentTaxYearAmt |
| Total | $140,524 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $7,022,631 | TotalSupportAmt |
| Public Support CY170 | 0.97980 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98670 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2014 AMOUNT: $ 12,579. 2015 AMOUNT: $ 24,000. 2016 AMOUNT: $ 37,005. 2018 AMOUNT: $ 66,940. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,000 | OtherCostOrOtherBasisAmt |
| Book Value | $50,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $688,302 | OtherCostOrOtherBasisAmt |
| Depreciation | $111,793 | DepreciationAmt |
| Book Value | $576,509 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $143,684 | OtherCostOrOtherBasisAmt |
| Depreciation | $120,457 | DepreciationAmt |
| Book Value | $23,227 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $649,736 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,810,830 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,810,830 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,810,830 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,863,995 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,863,995 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,863,995 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| FORM 990, PART VI, SECTION C, LINE 18 | ANNUAL AUDIT IS AVAILABLE TO FUNDING AGENCY AND PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 453,257. MANAGEMENT AND GENERAL EXPENSES 70,960. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 524,217. |
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