FURP.ORG / PUBLIC DATA EXPLORER

NORTH TEXAS AREA COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
NORTH TEXAS AREA COMMUNITY HEALTH CENTERS INC (EIN 54-2117989)
Tax period
2009-12-01 to 2010-11-30
Filed
2011-08-10
IRS object ID
201142229349301374
Schema version
2009v1.7
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)
Timestamp2011-08-10T12:57:58-07:00Timestamp
Tax Period End Date2010-11-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Sanford Baumeister & Frazier PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1512 Main Street Suite 1500AddressLine1
CityFort WorthCity
StateTXState
ZIP Code76102ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-12-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN542117989EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Fort Worth Northside CommunityBusinessNameLine1
Business Name Line2Health Center IncBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlFORTNameControl
Phone8175466477Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 N Main StAddressLine1
CityFort WorthCity
StateTXState
ZIP Code76164ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameARCADIO VIVEROSName
TitleCEOTitle
Date Signed2011-08-10DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameMichaela Cromar CPAName
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts2450927GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web Sitewww.aghc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionPROVIDE COMPREHENSIVE, AFFORDABLE, QUALITY, PRIMARY HEALTH CARE TO UNDERSERVED COMMUNITIES IN TARRANT COUNTY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees32TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year939256ContributionsGrantsPriorYear
Contributions Grants Current Year1443481ContributionsGrantsCurrentYear
Program Service Revenue Prior Year775129ProgramServiceRevenuePriorYear
Program Service Revenue CY1003693ProgramServiceRevenueCY
Investment Income Prior Year59InvestmentIncomePriorYear
Investment Income Current Year4InvestmentIncomeCurrentYear
Other Revenue Prior Year2267OtherRevenuePriorYear
Other Revenue Current Year3749OtherRevenueCurrentYear
Total Revenue Prior Year1716711TotalRevenuePriorYear
Total Revenue Current Year2450927TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1375664SalariesEtcPriorYear
Salaries Etc Current Year1388404SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year8602TotalFundrsngExpCurrentYear
Other Expense Prior Year481871OtherExpensePriorYear
Other Expenses Current Year904221OtherExpensesCurrentYear
Total Expenses Prior Year1857535TotalExpensesPriorYear
Total Expenses Current Year2292625TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-140824RevenuesLessExpensesPriorYear
Revenues Less Expenses CY158302RevenuesLessExpensesCY
Total Assets BOY435999TotalAssetsBOY
Total Assets EOY626555TotalAssetsEOY
Total Liabilities BOY306517TotalLiabilitiesBOY
Total Liabilities EOY338771TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY129482NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY287784NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE COMPREHENSIVE, AFFORDABLE, QUALITY, PRIMARY HEALTH CARE TO UNDERSERVED COMMUNITIES IN TARRANT COUNTY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1536064Expense
Revenue1003693Revenue
DescriptionThe organization provides primary health care to a predominantly uninsured and underinsured population in its two locations. During the company's last fiscal year, the clinics served nearly 7,000 patients and provided 19,565 patient visits. The clinics together provide family medicine, pediatrics, and OB/GYN services and collaborate with other area organizations and specialists to ensure comprehensive care for its patients.Description
Total Program Service Expense1536064TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees32NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
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 CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonToni RemorNamePerson
Telephone Number8175466477TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12100 N Main St Ste 107AddressLine1
CityFort WorthCity
StateTXState
ZIP Code76164ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerIndividual Trustee Or DirectorIndividualTrusteeOrDirectorKey EmployeeKeyEmployee
ZENAIDA RACASA
DOCTOR40.00X10270003081
TONI REMOR
CFO45.006542307851X
SARAPIO HERRERA
Director1.00000X
SANTIAGO ESPINOSA
Director1.00000X
ROSEMARY GALDIANO
Secretary2.00000XX
RAQUEL HINOJOS
Director1.00000X
MAURO SERRANO
Treasurer2.00000XX
LYDIA FRIAS
Director1.00000X
JOHN HERNANDEZ
Director1.00000X
GREG EASTIN
President2.00000XX
GLORIA WHEATFIELD
Director1.00000X
ELIZABETH TREVINO-DAWSON
Vice President2.00000XX
DR SAMUEL COLERIDGE
CMO30.0012903403871X
CHRISTENE MOSS
Director1.00000X
BEVERLY DUNN
Director1.00000X
ARMANDO FLORES
Director1.00000X
ARCADIO VIVEROS
CEO45.007125907608X
FieldValueIRS element (for citing)
Total Reportable Comp From Org368416TotalReportableCompFromOrg
Total Other Compensation22411TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LABCORP
PO BOX 12140BURLINGTONNC272162140LAB SERVICES151605
DENNETT CONSTRUCTION
2313 CULLEN STREETFORT WORTHTX76107CONSTRUCTION113023
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Government Grants1348436GovernmentGrants
All Other Contributions95045AllOtherContributions
Noncash Contributions83468NoncashContributions
Total Contributions1443481TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Services RevenueDescription
Total Revenue Column1003693TotalRevenueColumn
Related Or Exempt Function Income1003693RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1003693TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4TotalRevenueColumn
Exclusion$4ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Total Revenue Column3749TotalRevenueColumn
Exclusion$3,749ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3749TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2450927TotalRevenueColumn
Related Or Exempt Function Income1003693RelatedOrExemptFunctionIncome
Exclusion$3,753ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total326560Total
Program Services155974ProgramServices
Management And General170586ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total963080Total
Program Services698014ProgramServices
Management And General257199ManagementAndGeneral
Fundraising7867Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7581Total
Program Services6231ProgramServices
Management And General1282ManagementAndGeneral
Fundraising68Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7011Total
Program Services5064ProgramServices
Management And General1869ManagementAndGeneral
Fundraising78Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total84172Total
Program Services61053ProgramServices
Management And General22530ManagementAndGeneral
Fundraising589Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total79271Total
Program Services9852ProgramServices
Management And General69419ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total12189Total
Management And General12189ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total46751Total
Management And General46751ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total25086Total
Program Services6112ProgramServices
Management And General18974ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total7940Total
Program Services3907ProgramServices
Management And General4033ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total53358Total
Program Services13340ProgramServices
Management And General40018ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
TRAINING AND DEVELOPMENT307051604914656
Telephone20473945411019
SUPPLIES14799612046827528
DUES AND PUBLICATIONS27903793219971
CONTRACT LABOR4209044170453859

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total31645Total
Program Services5569ProgramServices
Management And General26076ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2292625Total
Program Services1536064ProgramServices
Management And General747959ManagementAndGeneral
Fundraising8602Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY69555BOY
EOY56145EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6002BOY
EOY26006EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY164053BOY
EOY195137EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY11925BOY
EOY16600EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis467802LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec140246LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY179353BOY
EOY327556EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5111BOY
EOY5111EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY435999BOY
EOY626555EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY182624BOY
EOY247456EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY123893BOY
EOY91315EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY306517BOY
EOY338771EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY129482BOY
EOY287784EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY129482BOY
EOY287784EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY435999BOY
EOY626555EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years318204CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1073197CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years901772CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year939256CurrentTaxYearMinus1Year
Current Tax Year1443481CurrentTaxYear
Total4675910Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years318204CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1073197CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years901772CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year939256CurrentTaxYearMinus1Year
Current Tax Year1443481CurrentTaxYear
Total4675910Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total313424AmountsSubstContributorsTotal
Public Support Total1704362486PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years4645CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2783CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year59CurrentTaxYearMinus1Year
Current Tax Year4CurrentTaxYear
Total7491Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year2267CurrentTaxYearMinus1Year
Current Tax Year3749CurrentTaxYear
Total6016Total
FieldValueIRS element (for citing)
Total Support4689417TotalSupport
Gross Receipts From Admissions Etc3282924GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.93030PublicSupportPertcentage170
Public Support Pertcent Prior Year0.87880PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis327735InvestmentCostOrOtherBasis
Depreciation140246Depreciation
Book Value187489BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis140067InvestmentCostOrOtherBasis
Book Value140067BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings327556TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionREPAYMENT OF DSHS GRANTDescription
Amount$91,315Amount
FieldValueIRS element (for citing)
Total Of Amounts91315TotalOfAmounts
Total Revenue2450927TotalRevenue
Total Expenses2292625TotalExpenses
Excess Or Deficit For Year158302ExcessOrDeficitForYear
Excess Or Deficit Per FS158302ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2582395TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities131468DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990131468RevenueNotRptdF990
Revenue Subtotal2450927RevenueSubtotal
Total Revenue Per Form9902450927TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2424093TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities131468DonatedServicesUseOfFacilities
Expenses Not Rptd F990131468ExpensesNotRptdF990
Expenses Subtotal2292625ExpensesSubtotal
Total Expenses Per Form9902292625TotalExpensesPerForm990

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F99083468NoncashContribsRptdF990
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNO DOCUMENTS AVAILABLE TO THE PUBLIC.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessTHE FORM 990 IS PRESENTED TO THE BOARD AND SIGNED BY THE CEO FOR MAILING TO THE IRS.