EBENZER MEDICAL OUTREACH INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
EBENZER MEDICAL OUTREACH INC (EIN 55-0745033)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-12
IRS object ID
201921329349300117
Schema version
2017v2.2
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

FieldValueIRS element (for citing)
Return2019-05-12T13:50:45-04:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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 Begin2017-07-01TaxPeriodBeginDt

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)
PersonAaron BlevinsPersonNm
Person TitleTreasurerPersonTitleTxt
Phone3046970565PhoneNum
Signature2019-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRUCE I SULLIVAN CPAPreparerPersonNm
PTINP00177743PTIN
Phone3046970565PhoneNum
Preparation2019-05-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address50.253.208.173IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-05-12IPDt
IP Tm13:54:05IPTm
Federal Original Submission Id5504622019132cfcynkoFederalOriginalSubmissionId
Federal Original Submission Id2019-05-12FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdF836474B97EE223A6C196EA729E0E598B562EEEDAtSubmissionCreationDeviceId
At Submission Filing Device IdF836474B97EE223A6C196EA729E0E598B562EEEDAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$1,391,122GrossReceiptsAmt
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 Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee10TotalEmployeeCnt
Total Volunteers35TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,143,515PYContributionsGrantsAmt
CY Contributions Grants$1,332,247CYContributionsGrantsAmt
PY Program Service Revenue$56,549PYProgramServiceRevenueAmt
CY Program Service Revenue$46,009CYProgramServiceRevenueAmt
PY Investment Income$1,894PYInvestmentIncomeAmt
CY Investment Income$2,046CYInvestmentIncomeAmt
PY Other Revenue$7,071PYOtherRevenueAmt
CY Other Revenue$10,595CYOtherRevenueAmt
PY Total Revenue$1,209,029PYTotalRevenueAmt
CY Total Revenue$1,390,897CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$222,791PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$220,043CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$893CYTotalFundraisingExpenseAmt
PY Other Expenses$917,497PYOtherExpensesAmt
CY Other Expenses$1,049,773CYOtherExpensesAmt
PY Total Expenses$1,140,288PYTotalExpensesAmt
CY Total Expenses$1,269,816CYTotalExpensesAmt
PY Revenues Less Expenses$68,741PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$121,081CYRevenuesLessExpensesAmt
Total Assets BOY$624,205TotalAssetsBOYAmt
Total Assets EOY$754,603TotalAssetsEOYAmt
Total Liabilities BOY$175,508TotalLiabilitiesBOYAmt
Total Liabilities EOY$180,429TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$448,697NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$574,174NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE MEDICAL SERVICES TO THE UNINSUREDMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,268,079ExpenseAmt
Revenue$46,009RevenueAmt
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$1,268,079TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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
Employee10EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
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 (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
CHRISTIE KINSEY
PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
STEPHEN PETRANY
VICE PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
SUE MCCLELLAND
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
AARON BLEVINS
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
FRAN DEGIDIO
BOARD MEMBER1.000.00Yes (X)$0$0$0
JANE FOTOS
BOARD MEMBER1.000.00Yes (X)$0$0$0
HOYT J BURDICK
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
LEO FLECKENSTEIN
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHERYL HENDERSON
BOARD MEMBER1.000.00Yes (X)$0$0$0
LISA MARTIN
BOARD MEMBER1.000.00Yes (X)$0$0$0
SARAH DENMAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
DERON RUNYON
BOARD MEMBER1.000.00Yes (X)$0$0$0
DENISE LANDRY
BOARD MEMBER1.000.00Yes (X)$0$0$0
MATT CHRISTIANSEN
BOARD MEMBER1.000.00Yes (X)$0$0$0
DAVID ELLER
BOARD MEMBER1.000.00Yes (X)$0$0$0
DEB KOESTER
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHRISTOPHER PLYBON
BORD MEMBER1.000.00Yes (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
Government Grants$355,126GovernmentGrantsAmt
All Other Contributions$977,121AllOtherContributionsAmt
Noncash Contributions$839,149NoncashContributionsAmt
Total Contributions$1,332,247TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescBILLINGSDesc
Business621400BusinessCd
Total Revenue Column$46,009TotalRevenueColumnAmt
Related Or Exempt Func Income$46,009RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$46,009TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,046TotalRevenueColumnAmt
Related Or Exempt Func Income$2,046RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$10,137FundraisingGrossIncomeAmt
Fundraising Direct Expenses$225FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,912TotalRevenueColumnAmt
Exclusion$9,912ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$683TotalRevenueColumnAmt
Related Or Exempt Func Income$683RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$683OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,390,897TotalRevenueColumnAmt
Related Or Exempt Func Income$48,738RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$9,912ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$41,008TotalAmt
Program Services$41,008ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$161,148TotalAmt
Program Services$161,148ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$17,887TotalAmt
Program Services$17,887ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$13,891TotalAmt
Program Services$13,891ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$103,282TotalAmt
Program Services$103,282ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$412TotalAmt
Program Services$412ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,323TotalAmt
Program Services$1,323ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,557TotalAmt
Program Services$10,557ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,366TotalAmt
Program Services$4,366ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
CONTRIBUTED SUPPLIES AND EQ$839,149$839,149
PROFESSIONAL COSTS & OTHER$24,880$24,880
EQUIPMENT PURCHASERENTAL$12,751$12,751
SUPPLIES$16,482$16,482

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$22,680TotalAmt
Program Services$20,943ProgramServicesAmt
Management And General$844ManagementAndGeneralAmt
Fundraising$893FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,269,816TotalAmt
Program Services$1,268,079ProgramServicesAmt
Management And General$844ManagementAndGeneralAmt
Fundraising$893FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$478,740BOYAmt
EOY$493,420EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,989BOYAmt
EOY$20,918EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$29,773BOYAmt
EOY$20,616EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,922BOYAmt
EOY$1,860EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$399,524LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$270,127LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$23,566BOYAmt
EOY$129,397EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$22,293BOYAmt
EOY$24,273EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$59,922BOYAmt
EOY$64,119EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$624,205BOYAmt
EOY$754,603EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$175,508BOYAmt
EOY$180,429EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$175,508BOYAmt
EOY$180,429EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$388,455BOYAmt
EOY$498,640EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,158BOYAmt
EOY$19,142EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$53,084BOYAmt
EOY$56,392EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$448,697BOYAmt
EOY$574,174EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$624,205BOYAmt
EOY$754,603EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$121,081ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,396NetUnrlzdGainsLossesInvstAmt
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$2,100,357CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,271,826CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,240,739CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,143,515CurrentTaxYearMinus1YearAmt
Current Tax Year$1,332,247CurrentTaxYearAmt
Total$7,088,684TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,100,357CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,271,826CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,240,739CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,143,515CurrentTaxYearMinus1YearAmt
Current Tax Year$1,332,247CurrentTaxYearAmt
Total$7,088,684TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$108,783SubstantialContributorsTotAmt
Public Support Total170$6,979,901PublicSupportTotal170Amt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$33,387CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,916CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,907CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,050CurrentTaxYearMinus1YearAmt
Current Tax Year$9,912CurrentTaxYearAmt
Total$77,172TotalAmt
FieldValueIRS element (for citing)
Total Support$7,165,856TotalSupportAmt
Gross Receipts Rltd Activities$214,892GrossReceiptsRltdActivitiesAmt
Public Support CY1700.97400PublicSupportCY170Pct
Public Support PY1700.99500PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,213BeginningYearBalanceAmt
Investment Earnings Or Losses$195InvestmentEarningsOrLossesAmt
End Year Balance$54,408EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$53,709BeginningYearBalanceAmt
Investment Earnings Or Losses$504InvestmentEarningsOrLossesAmt
End Year Balance$54,213EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$47,207BeginningYearBalanceAmt
Investment Earnings Or Losses$6,502InvestmentEarningsOrLossesAmt
End Year Balance$53,709EndYearBalanceAmt
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$399,524InvestmentCostOrOtherBasisAmt
Depreciation$270,127DepreciationAmt
Book Value$129,397BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$129,397TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST-DENTAL FUNDDesc
Book Value$64,119BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$64,119TotalBookValueOtherAssetsAmt

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 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$839,149NoncashContributionsRptF990Amt
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-$2,447ShareOfTotalIncomeAmt
Share Of EOY Assets$345,023ShareOfEOYAssetsAmt
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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