NORTHWEST BEHAVIORAL HEALTH SERVICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST BEHAVIORAL HEALTH SERVICES INC (EIN 59-3128476)
Tax period
2010-07-01 to 2011-06-30
Filed
2011-12-12
IRS object ID
201103469349300550
Schema version
2010v3.4
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)
Timestamp2011-12-12T12:00:53-06:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLEIMAN & COMPANY PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line19471 BAYMEADOWS RD SUITE 308AddressLine1
CityJACKSONVILLECity
StateFLState
ZIP Code32256ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN593128476EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST BEHAVIORAL HEALTH SERVICEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone9047817797Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12392 EDGEWOOD AVENUEAddressLine1
CityJACKSONVILLECity
StateFLState
ZIP Code32254ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePATRICIA SAMPSONName
TitleEXECUTIVE DIRECTORTitle
Phone9047817797Phone
Date Signed2011-11-30DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS C PLEIMAN JRName
Phone9044485005Phone
Date Prepared2011-11-30DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts2701405GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Activity Or Mission DescriptionMENTAL HEALTH AND SOCIAL REHABILITATION SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees62TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1583358ContributionsGrantsPriorYear
Contributions Grants Current Year1632690ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1247646ProgramServiceRevenuePriorYear
Program Service Revenue CY1068715ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2831004TotalRevenuePriorYear
Total Revenue Current Year2701405TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1913981SalariesEtcPriorYear
Salaries Etc Current Year1802048SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year934136OtherExpensePriorYear
Other Expenses Current Year952867OtherExpensesCurrentYear
Total Expenses Prior Year2848117TotalExpensesPriorYear
Total Expenses Current Year2754915TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-17113RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-53510RevenuesLessExpensesCY
Total Assets BOY1017020TotalAssetsBOY
Total Assets EOY1000526TotalAssetsEOY
Total Liabilities BOY280741TotalLiabilitiesBOY
Total Liabilities EOY317757TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY736279NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY682769NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMENTAL HEALTH AND SOCIAL REHABILITATION SERVICESMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense935008Expense
DescriptionMENTAL HEALTH CASE MANAGEMENT SERVICES PROVIDED TO TARGET ADULT POPULATION IN NORTHWEST QUADRANT OF DUVAL COUNTY.APPROXIMATELY 789 CLIENTS WERE SERVED DURING YEAR.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense739980Expense
DescriptionSOCIAL REHABILITATIVE SERVICES PROVIDED TO TARGETED POPULATION IN THE NORTHWEST QUADRANT OF DUVAL COUNTY. APPROXIMATELY 66 CLIENTS WERE SERVED DURING THE YEAR.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense739968Expense
DescriptionMENTAL HEALTH TREATMENT SERVICES PROVIDED TO THE CHILDREN POPULATION IN THE NORTHWEST QUADRANT OF DUVAL COUNTY.APPROXIMAELY 463 WERE SERVED DURING THE YEAR.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense88779Expense
DescriptionCOMMUNITY SERVICESDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp88779TotalOfOtherProgramServiceExp
Total Program Service Expense2503735TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With109638NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees62NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMELLEN BARNESNamePerson
Telephone Number9047817797TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12392 N EDGEWOOD AAddressLine1
CityJACKSONVILLECity
StateFLState
ZIP Code32254ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per WeekAverageHoursPerWeekOfficerOfficer
STEWARD WASHINGTON
BOARD MEMBERX000
RAYMOND CAMPBELL
BOARD MEMBERX000
CLIFTON COLEMAN
BOARD MEMBERX000
PADRICA MENDEZ
BOARD MEMBERX000
HOWARD SAVAGE II
BOARD MEMBERX000
ANN BLACKSHEAR
BOARD MEMBERX000
OREATHA COLVIN
BOARD MEMBERX000
MELLEN BARNES
BUSINESS MANX00040.00
MAGDALENE HOPES
PRESIDENT000X
REGINALD ESTELL JR
PARLIAMENTAR000X
MARIE HEATH
SECRETARY000X
NINA HARLEY
VICE-PRESIDE000X
ODEAN THOMAS
TREASURER000X
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants1581843GovernmentGrants
All Other Contributions50847AllOtherContributions
Total Contributions1632690TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID10244581024458
OTHER4425744257
FieldValueIRS element (for citing)
Total Program Service Revenue1068715TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2701405TotalRevenueColumn
Related Or Exempt Function Income1068715RelatedOrExemptFunctionIncome

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1422559Total
Program Services1287964ProgramServices
Management And General134595ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total259622Total
Program Services234252ProgramServices
Management And General25370ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total119867Total
Program Services108607ProgramServices
Management And General11260ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total88Total
Program Services88ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total26542Total
Program Services17347ProgramServices
Management And General9195ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total25Total
Program Services25ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total158306Total
Program Services133000ProgramServices
Management And General25306ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total50745Total
Program Services49030ProgramServices
Management And General1715ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total19444Total
Program Services19072ProgramServices
Management And General372ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total19525Total
Program Services14100ProgramServices
Management And General5425ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONSULTANTS AND SUBCONTRA2613192546746645
CLIENT SERVICES173030173030
PSYCHIATRIST124000124000
TELEPHONE27008211275881
OTHER21507797913528

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total71328Total
Program Services59440ProgramServices
Management And General11888ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2754915Total
Program Services2503735ProgramServices
Management And General251180ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY266730BOY
EOY1798EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY30269BOY
EOY248625EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY86286BOY
EOY79983EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY112642BOY
EOY90642EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1622BOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis765632LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec189754LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY519471BOY
EOY575878EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY3600EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1017020BOY
EOY1000526EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY234244BOY
EOY295843EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY46497BOY
EOY21914EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY280741BOY
EOY317757EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY736279BOY
EOY682769EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY736279BOY
EOY682769EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1017020BOY
EOY1000526EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-53510ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1515573CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1776008CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1519530CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1515305CurrentTaxYearMinus1Year
Current Tax Year1632690CurrentTaxYear
Total7959106Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1515573CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1776008CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1519530CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1515305CurrentTaxYearMinus1Year
Current Tax Year1632690CurrentTaxYear
Total7959106Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total4651929AmountsSubstContributorsTotal
Public Support Total1703307177PublicSupportTotal170
Total Support7959106TotalSupport
Gross Receipts From Admissions Etc1068715GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.41550PublicSupportPertcentage170
Public Support Pertcent Prior Year0.21420PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionWACHOVIA BANKDescription
Amount$21,914Amount
FieldValueIRS element (for citing)
Total Of Amounts21914TotalOfAmounts
Total Revenue2701405TotalRevenue
Total Expenses2754915TotalExpenses
Excess Or Deficit For Year-53510ExcessOrDeficitForYear
Excess Or Deficit Per FS-53510ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2701405TotRevenueEtcAuditedFinclStmt
Revenue Subtotal2701405RevenueSubtotal
Total Revenue Per Form9902701405TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2754915TotExpensesEtcAuditedFinclStmt
Expenses Subtotal2754915ExpensesSubtotal
Total Expenses Per Form9902754915TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ALL OTHER ACHIEVEMENTS DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DCOMMUNITY SERVICES
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC

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