2023-11-15T08:53:28-06:00 2022-12-31 521022232 SNYDER COHN PC 11200 ROCKVILLE PIKE SUITE 415 NORTH BETHESDA MD 20852 990 2022-01-01 562273242 NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC NATI 7036477427 1800 DIAGONAL ROAD SUITE 600 ALEXANDRIA VA 223142840 NICOLE LAMOUREUX PRESIDENT/CEO 7036477427 2023-11-15 1 NICOLE LAMOUREUX XXX-XX-XXXX 1 KEITH JENNINGS P01319883 3016526700 2023-11-15 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z NICOLE LAMOUREUX 1800 DIAGONAL ROAD SUITE 600 ALEXANDRIA VA 223142840 4264994 0 X WWW.NAFCCLINICS.ORG X 2003 VA TO ENSURE THAT THE MEDICALLY UNDERSERVED HAVE ACCESS TO AFFORDABLE QUALITY HEALTH CARE. 14 14 5 14 0 0 7703358 3382370 616955 716693 24822 26831 0 0 8345135 4125894 5685359 3530340 0 0 532486 606443 0 0 89106 1492300 1156912 7710145 5293695 634990 -1167801 2287397 2875563 483859 779229 1803538 2096334 BUILDING HEALTHY COMMUNITIES FOR ALL THROUGH QUALITY, EQUITABLE, ACCESSIBLE HEALTHCARE. 0 0 1028724 676693 THE NAFC ANNUAL SYMPOSIUM AND ADDITIONAL EDUCATION SERVICES ARE THE ONLY NATIONAL MEETING SOLELY DEDICATED TO PROVIDING HEALTH EDUCATION AND TRAINING FOR NAFC STAFF AND VOLUNTEERS WHO PROVIDE HEALTH CARE TO THE MEDICALLY UNDERSERVED. 3684206 3530340 40000 CLINICS ESTABLISH AND MAINTAIN SERVICES THAT SUPPORT AND BENEFIT THE WORK OF THE MEMBERS IN THEIR EFFORTS TO PROVIDE HEALTH CARE TO THE UNINSURED AND UNDERINSURED. 4712930 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 5 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AR CA FL GA IL KS KY MD MA MI MN NH NJ NM NY NC OR PA RI SC TN UT VT VA WV WI X THE ORGANIZATION 7036477427 1800 DIAGONAL ROAD SUITE 600 ALEXANDRIA VA 223142840 STEPHANIE NELSON GARRIS JD CHAIRMAN 3.00 X X 0 0 0 MAUREEN TOMOSCHUK VICE CHAIRMAN 3.00 X X 0 0 0 BETH ARMSTRONG TREASURER 3.00 X X 0 0 0 ISI IKHAREBHA GREEN SECRETARY 3.00 X X 0 0 0 DR HINA AZAM BOARD MEMBER 3.00 X 0 0 0 ADAM BRADLEY BOARD MEMBER 3.00 X 0 0 0 GISELA BRETONES BOARD MEMBER 3.00 X 0 0 0 NANCY W HUDSON BOARD MEMBER 3.00 X 0 0 0 AVONTE JACKSON BOARD MEMBER 3.00 X 0 0 0 BOBBY KAPUR BOARD MEMBER 3.00 X 0 0 0 KAT MASTRANGELO BOARD MEMBER 3.00 X 0 0 0 ANGIE MCLAUGHLIN BOARD MEMBER 3.00 X 0 0 0 LARRY S ROBINS BOARD MEMBER 3.00 X 0 0 0 SHANNON WATSON BOARD MEMBER 3.00 X 0 0 0 NICOLE LAMOUREUX CHIEF EXECUTIVE OFFICER 40.00 X 196032 0 5881 KERRY THOMPSON VICE PRESIDENT 40.00 X 135000 0 9531 331032 0 15412 2 0 1 0 MWW GROUP LLC PO BOX 67186 NEWARK NJ 071016602 PUBLIC RELATIONS 153539 1 3382370 3382370 MEMBERSHIP DUES 621400 413588 413588 SYMPOSIUM 621400 263105 263105 BIOGEN 621400 40000 40000 716693 28077 28077 137854 139100 -1246 -1246 -1246 4125894 716693 0 26831 3530340 3530340 163338 127631 12784 22923 380953 255729 120556 4668 62152 44595 14336 3221 402575 201101 148254 53220 100396 23128 77268 2181 1714 467 126587 70240 51273 5074 37891 37825 66 12325 12325 10516 10516 SYMPOSIUM 347218 347218 TELEPHONE AND WEBSITE 112380 68673 43707 POSTAGE AND SHIPPING 4843 4736 107 5293695 4712930 491659 89106 538605 1789377 826273 67077 52005 146048 15200 24620 56256 45403 30371 18190 15032 692378 671313 41283 209303 2287397 2875563 220994 195952 10000 195000 252865 186345 0 201932 483859 779229 X 1803538 1663600 432734 1803538 2096334 2287397 2875563 X -1167801 -66532 1527129 0 X 0 1 X 1 0 X 3517698 3180507 4631838 7108792 3475267 21914102 716693 716693 3517698 3180507 4631838 7108792 4191960 22630795 0 0 0 22630795 16704 42284 30323 25335 35138 149784 16704 42284 30323 25335 35138 149784 299573 299573 3534402 3222791 4961734 7134127 4227098 23080152 0.98050 0.97870 0.00650 0.00650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32253 18380 13873 13150 11991 1159 15032 INVESTMENTS 671313 F 671313 WEBSITE DEVELOPMENT COSTS 16041 SECURITY DEPOSIT 8680 RIGHT OF USE ASSETS 183882 DUE FROM OTHERS 700 209303 LEASE LIABILITIES 201932 201932 X 4128761 -66532 69399 2867 4125894 0 4125894 5363092 69397 69397 5293695 0 5293695 PART X, LINE 2: THE ASSOCIATION ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD TO THE RECOGNITION OF TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX EFFECT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR UNCERTAIN TAX POSITIONS. INTEREST AND PENALTIES, IF ANY, ARE ACCRUED AS A COMPONENT OF GENERAL AND ADMINISTRATIVE EXPENSES WHEN ASSESSED. THE ASSOCIATION HAS IDENTIFIED ITS TAX STATUS AS A TAX-EXEMPT ENTITY UNDER SECTION 501(C)(3) AND ITS DETERMINATION THAT IT HAS NO UNRELATED BUSINESS INCOME AS TAX POSITIONS; HOWEVER, THE ASSOCIATION HAS DETERMINED THAT SUCH TAX POSITIONS DO NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. INCOME TAX YEARS ENDED PRIOR TO DECEMBER 31, 2019 ARE NO LONGER SUBJECT TO AUDIT BY TAXING AUTHORITIES. 1 ARLINGTON FREE CLINIC 2921 11TH STREET SOUTH ARLINGTON VA 22204 541671883 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CITY ON A HILL HEALTH CLINIC 100 PINE ST ZEELAND MI 49464 203901260 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED COMMUNITY ADVANCED PRACTICE NURSES 173 BOULEVARD NE ATLANTA GA 303121468 582435328 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED COMMUNITYHEALTH 2611 W CHICAGO AVE CHICAGO IL 60622 363831793 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GRACE CLINIC OF YADKIN VALLEY 948 JOHNSON RIDGE RD ELKIN NC 28621 760800084 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED HEAL THE CITY FREE CLINIC P O BOX 2556 AMARILLO TX 79105 465694050 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED HEALTHNET OF ROCK COUNTY INC 23 W MILWAUKEE ST STE 201 JANESVILLE WI 53548 391778804 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED JEWISH FAMILY SERVICE OF COLORADO 3201 S TAMARAC DR DENVER CO 802314360 840402701 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MATTHEWS FREE MEDICAL CLINIC 196 S TRADE ST MATTHEWS MATTHEWS NC 281055772 510468874 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MOUNTAIN HOPE GOOD SHEPHERD CLINIC INC PO BOX 5937 SEVIERVILLE TN 37864 621747037 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED POINT WASHINGTON MEDICAL CLINIC INC 1290 N CO HWY 395 SANTA ROSA BEACH FL 32459 831125021 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED REFUGE CLINIC 2349 RICHMOND ROAD SUITE 220 LEXINGTON KY 40502 371547506 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SALEM FREE CLINICS 1300 BROADWAY ST NE STE 104 SALEM OR 97301 203549992 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SHEPHERD'S CLINIC 2800 KIRK AVE BALTIMORE MD 21218 521739001 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SMITHVILLE COMMUNITY CLINIC PO BOX 38 300 LYNCH STREET SMITHVILLE TX 78957 204515999 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED ST LUKE'S FREE MEDICAL CLINIC PO BOX 3466 SPARTANBURG SC 29304 570943232 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED TEMPLE COMMUNITY CLINIC 1905 CURTIS B ELLIOTT DRIVE TEMPLE TX 76501 742634500 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE HEALTH HUT 310 WEST MISSISSIPPI AVE RUSTON LA 71270 273764078 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED UNIVERSAL MEDICAL INSTITUTE INC 99 NW 183RD ST SUITE 133A MIAMI FL 33027 850504960 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED VIM BERKSHIRES 777 MAIN STREET SUITE 4 GREAT BARRINGTON MA 01230 900140004 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED VOLUNTEERS IN MEDICINE - PA 190 N PENNSYLVANIA AVE WILKES BARRE PA 18702 203531527 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED C-ASSIST 30260 CHERRY HILL GARDEN CITY MI 48135 813386484 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CARELINK OF NORTHWEST GEORGIA INC PO BOX 182 DALLAS GA 30132 475094465 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CATHOLIC CHARITIES OF CENTRAL FLORIDA 1819 N SEMORAN BLVD ORLANDO FL 32807 591214353 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CENTRE VOLUNTEERS IN MEDICINE 2520 GREEN TECH DRIVE SUITE D STATE COLLEGE PA 16803 251897969 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CHICAGO WOMEN'S HEALTH CENTER 1025 WEST SUNNYSIDE AVE 201 CHICAGO IL 60640 362922469 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED COMMUNITY HEALTH CLINIC INC 1113 WOODLAND DR ELIZABETHTOWN KY 42701 300042070 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED FREE CLINIC OF CENTRAL VIRGINIA INC 1016 MAIN STREET LYNCHBURG VA 24504 541420756 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED FREE CLINIC OF ROCKINGHAM COUNTY INC PO BOX 2668 REIDSVILLE NC 27323 562003143 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GEORGIA CHARITABLE CARE NETWORK INC PO BOX 133224 ATLANTA GA 30333 800100336 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GRATIS HEALTHCARE PO BOX 644 FRANKLIN MA 02038 311741660 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED ILLINOIS ASSOCIATION OF FREE AND CHARITABLE CLINICS 42 STEPHEN STREET 416 LEMONT IL 60439 201942444 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LAHAI HEALTH 19820 SCRIBER LAKE RD 2 LYNNWOOD WA 98036 331052418 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LIFESPRING COMMUNITY HEALTH 1042 EAST 3RD STREET SUITE 200 CHATTANOOGA TN 37403 273856741 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MEMPHIS MUSLIM MEDICAL SERVICES INC 1055 STRATFORD ROAD MEMPHIS TN 38122 412153994 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED OPEN ARMS HEALTH CLINIC INC 3311 LITTLE ROAD ARLINGTON TX 76016 450621201 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED PEOPLE'S HEALTH & WELLNESS CLINIC PO BOX 544 BARRE VT 05641 030343290 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SOUTH COUNTY COMMUNITY CLINIC DBA INTERFAITH COMMUNITY CLINIC 101 PINE MANOR WAY OAK RIDGE NORTH TX 77385 752634623 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE COMMUNITY CLINIC OF SOUTHWEST MISSOURI 701 S JOPLIN AVENUE JOPLIN MO 64801 431643962 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE LUKE PROJECT 52 CLINIC (DBA THE LUKE CLINIC) 9615 MAIN ST SUITE B WHITMORE LAKE MI 48189 812779813 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED TRS HEALTH INC 3727 GREENBRIAR DR STE 114 STAFFORD TX 77477 842546001 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED WEST VIRGINIA HEALTH RIGHT INC 1520 WASHINGTON STREET EAST CHARLESTON WV 25311 311066881 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED WORRY FREE COMMUNITY 1701 BLOOMINGDALE RD GLENDALE HEIGHTS IL 60139 474911621 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MEDICAL UNIVERSITY OF SOUTH CAROLINA FOUNDATION PO BOX 250450 CHARLESTON SC 29425 576028985 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GREENVILLE FREE MEDICAL CLINIC PO BOX 8993 GREENVILLE SC 29604 570855205 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED HEALTH ALLIANCE FOR THE UNINSURED 3000 UNITED FOUNDERS BLVD STE 244 OKLAHOMA CITY OK 73112 261789292 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED TXACC PO BOX 684127 AUSTIN TX 78768 331115138 501(C)(3) 15000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED VAFCC 1401 LIBBIE AVENUE SUITE 104 RICHMOND VA 23226 541802019 501(C)(3) 15000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED WHEELING HEALTH RIGHT INC 61-29TH ST WHEELING WV 26003 311149085 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED 4TH SECOND 839 VALLE VISTA AVE VALLEJO CA 94590 273215926 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED BERKELEY COMMUNITY HEALTH PROJECT 2339 DURANT AVE BERKELEY CA 94704 941697002 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CALIFORNIA ASSOCIATION OF FREE AND CHARITABLE CLINICS 2752 ABEJORRO ST CARLSBAD CA 92009 202198446 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CENTER FOR FAMILY HEALTH AND EDUCATION INC 8727 VAN NUYS BLVD STE 101 PANORAMA CITY CA 91402 270224623 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CLINICA TEPATI 1820 J STREET SACRAMENTO CA 95811 942324682 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED COACHELLA VALLEY VOLUNTEERS IN MEDICINE PO BOX 10090 INDIO CA 92202 263312826 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED COMMUNITY SERVICE EDUCATION AND RESEARCH FUND OF SEDMS 5380 ELVAS AVE SUITE 101 SACRAMENTO CA 95819 237003581 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CONEJO FREE CLINIC 80 E HILLCREST DRIVE SUITE 102 THOUSAND OAKS CA 91360 953177953 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GRASSROOTS HEALTHCARE FOUNDATION 743 E TABOR AVE FAIRFIELD CA 94533 FAIRFIELD CA 94533 320600776 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED HEALING GROVE HEALTH CENTER INC A SOCIAL PURPOSE CORPORATION 226 W ALMA AVE SUITE 10 SAN JOSE CA 95110 844194962 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INLAND EMPIRE FREE CLINIC 1501 VIOLET ST OFFICE 386 COLTON CA 92324 871142032 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED NADEZHDA HEALTH PROJECT 1 SHIELDS AVENUE CSI BOX 795 DAVIS CA 95616 822852928 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED NAPA ACUPUNCTURE PRACTICE 411 FREEWAY DR NAPA CA 945585869 814145087 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED POINT LOMA NAZARENE UNIVERSITY HEALTH PROMOTION CENTER 4101 UNIVERSITY AVE SAN DIEGO CA 92105 951644035 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SAN FRANCISCO FREE CLINIC 4900 CALIFORNIA STREET SAN FRANCISCO CA 94118 943186248 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SOUTHERN CALIFORNIA CARE COMMUNITY 120 N ASH ST ESCONDIDO CA 92027 850858493 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE WILLOW CLINIC 1200 NORTH B STREET SACRAMENTO CA 95814 800721010 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED UMI COMMUNITY IMAGING CLINIC 24901 VIA VERDE LAGUNA NIGUEL CA 92677 832309570 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED VIDA MOBILE CLINIC 10718 WHITE OAK AVE UNIT 6 GRANADA HILLS CA 913444628 814209248 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED WOMEN AND INFANTS MOBILE HEALTH 1 GRAND AVE SAN LUIS OBISPO CA 93407 951648180 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED ROTACARE BAY AREA INC 514 VALLEY WAY MILPITAS CA 95035 770328723 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SLO NOOR FOUNDATION A NON-PROFIT CORPORATION 1428 PHILLIPS LN STE 203 SAN LUIS OBISPO CA 93401 271412176 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SYMBA CENTER 20601 HWY 18 SUITE 171 APPLE VALLEY CA 92307 843729902 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED VOLUNTEERS IN MEDICINE SAN FRANCISCO - DBA CLINIC BY THE BAY 4877 MISSION ST SAN FRANCISCO CA 94112 262593712 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED JEWISH COMMUNITY FREE CLINIC 50 MONTGOMERY DRIVE SANTA ROSA CA 95405 943386103 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED DESERT ROSE TRAUMA RECOVERY 15431 ANACAPA RD STE H VICTORVILLE CA 92392 204172018 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED WESTMINSTER FREE CLINIC 2673 SAN MIGUEL CIRCLE THOUSAND OAKS CA 81360 770563241 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LESTONNAC FREE CLINIC 1215 E CHAPMAN ORANGE CA 92866 953499011 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CLARA'S HOUSE 2700 L STREET SACRAMENTO CA 95819 611591265 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED JACKSON FREE CLINIC 925 MARTIN LUTHER KING JR DRIVE JACKSON MS 39203 640945749 501(C)(3) 43570 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SISTERS IN BIRTH 5839 S PEAR ORCHARD ROAD JACKSON MS 39211 812072883 501(C)(3) 43570 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED FREE CLINIC ASSOCIATION OF PENNSYLVANIA 2520 GREEN TECH DRIVE STATE COLLEGE PA 16803 260099669 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE GOOD SAMARITAN HEALTH CENTER 1015 DONALD LEE HOLLOWELL PARKWAY ATLANTA GA 30329 582373395 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CARE RING 601 E FIFTH STREET SUITE 140 CHARLOTTE NC 28202 560621073 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GRACE MEDICAL HOME INC 1417 E CONCORD STREET ORLANDO FL 32803 261817966 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED IBN SINA FOUNDATION INC 11226 SOUTH WILCREST DR HOUSTON TX 77099 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED IMANI CLINIC 2425 ALHAMBRA BLVD SACRAMENTO CA 95817 352505613 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LUKE PROJECT - 52 CLINIC INCORPORATED 9615 MAIN ST SUITE B WHITMORE LAKE MI 48189 812779813 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED PREMIER MOBILE HEALTH SERVICES 10676 COLONIAL BLVD STE 20 FORT MYERS FL 339138715 825372657 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED UNR STUDENT OUTREACH CLINIC 745 W MOANA LANE RENO NV 89509 942781749 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED UBI CARITAS 4450 HIGHLAND AVE BEAUMONT TX 77705 760558225 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED UBUNTU BLACK FAMILY WELLNESS COLLECTIVE 2611 GOVERNOR PRINTZ BLVD WILMINGTON DE 19802 844324815 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED WAY FREE MEDICAL CLINIC INC 479 HOUSTON ST GREEN COVE SPRINGS FL 320432411 760828154 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED HELPING HANDS OF MIDDLE & WEST TENNESSEE 1408 NORTH HIGHLAND AVENUE JACKSON TN 38301 811043752 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CHARITABLE PHARMACY OF CENTRAL OHIO 200 E LIVINGSTON AVE COLUMBUS OH 43215 270147099 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LA CLINICA LATINA 2231 N HIGH STREET COLUMBUS OH 43201 205260283 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MATTHEW 25 INC 413 E JEFFERSON BLVDFORT WAYNE FORT WAYNE IN 46845 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MIDVALE COMMUNITY BUILDING COMMUNITY INC 49 W CENTER STREET MIDVALE UT 84047 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED RHODE ISLAND FREE CLINIC 655 BROAD STREET 3RD FLOOR PROVIDENCE RI 02907 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE HEALTH WAGON PO BOX 7070 WISE VA 24293 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED STUDENT OUTREACH TO AREA RESIDENTS LLC 4209 ST RT 44 ROOTSTOWN OH 44272 464173762 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MIDVALE COMMUNITY BUILDING COMMUNITY INC 49 WEST CENTER STREET 1 MIDVALE UT 84047 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE BREATHING ASSOCIATION 788 MOUNT VERNON AVENUE COLUMBUS OH 43203 314387540 501(C)(3) 10000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED MEDICAL MISSION ADVENTURES 425 SIERRA MADRE VILLA AVE PASADENA CA 91107 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CHARITABLE HEALTHCARE NETWORK 88 E BROAD ST STE 1475 COLUMBUS OH 43215 223769296 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED CHARITABLE PHARMACY OF CENTRAL OHIO 200 E LIVINGSTON AVE COLUMBUS OH 43215 270147099 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED COLUMBUS FREE CLINIC 2231 N HIGH ST COLUMBUS OH 43201 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GOOD NEIGHBOR HOUSE 627 EAST FIRST STREET DAYTON OH 45402 311374154 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED GRACE CLINICS OF OHIO PO BOX 444 DELAWARE OH 43015 270415624 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED HELPING HANDS HEALTH AND WELLNESS CENTER 5100 KARL RD COLUMBUS OH 43229 205937457 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LAKE COUNTY FREE CLINIC 125 E ERIE STREET LOWER LEVEL PAINESVILLE OH 44077 341081191 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED LIVING WELL CLINIC 1160 N MONROE DR XENIA OH 45385 274307745 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED OHIO LATINO HEALTHCARE NETWORK 2231 N HIGH ST COLUMBUS OH 43201 205260283 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED OHIO VALLEY HEALTH CENTER 423 SOUTH ST STEUBENVILLE OH 43952 203924355 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED PHYSICIANS CARECONNECTION 1390 DUBLIN RD COLUMBUS OH 43215 311373719 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED REACH OUT OF MONTGOMERY COUNTY 25 E FORAKER DAYTON OH 45409 311434292 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED RISING SUNS NON - PROFIT PHARMACY PO BOX 193 ATHENS OH 45701 842852530 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SOAR STUDENT RUN FREE CLINIC LLC AT NEOMED CLINICAL INITIATIVES 4209 STATE ROUTE 44 ROOTSTOWN OH 44272 464173762 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED SALAAM CLEVELAND DBA SALAAM CLINIC 1925 ST CLAIR AVE NE CLEVELAND OH 44114 261368320 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED ST VINCENT DE PAUL CHARITABLE PHARMACY 1125 BANK STREET CINCINNATI OH 45214 300272954 501(C)(3) 30000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED THE BREATHING ASSOCIATION 788 MOUNT VERNON AVE COLUMBUS OH 43203 314387540 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED VIOLA STARTZMAN CLINIC 1874 CLEVELAND RD WOOSTER OH 44691 341758151 501(C)(3) 25000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED TOLEDOLUCAS COUNTY CARENET 3231 CENTRAL PARK W STE 200 TOLEDO OH 43617 431986672 501(C)(3) 20000 0 TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED 122 PART I, LINE 2: GRANT FUNDING CLINICS MUST SIGN A LETTER THAT STATES THEY UNDERSTAND THE REQUIREMENTS OF THE GRANT AND THEY MUST REPORT TWO TIMES A YEAR USING AN ELECTRONIC PORTAL. A REPORT IS MADE TO SUMMARIZE THE FUNDS STATUS. X X 0 0 0 0 0 0 0 0 0 NICOLE LAMOUREUX CHIEF EXECUTIVE OFFICER 196032 0 0 0 0 0 5881 0 0 0 201913 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP IS COMPOSED OF FREE CLINICS AROUND THE COUNTRY THAT PAY DUES TO BE A MEMBER. THE BOARD IS ELECTED AT AN ANNUAL MEETING OF THE MEMBERSHIP OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT OFFICERS AT THE ANNUAL MEETING OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS ARE PROVIDED WITH A DRAFT OF THE 990 AND GIVEN A PERIOD OF TIME FOR REVIEW AND COMMENTS PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MUST SIGN THE CONFLICT OF INTEREST FORM AND BOARD COMMITMENT FORM ANNUALLY AND RETURN TO THE NAFC STAFF. FORM 990, PART VI, SECTION B, LINE 15 THERE IS AN EXECUTIVE COMMETTEE ESTABLISHED WHO REVIEWS AND SETS THE GOALS FOR THE CEO POSITION. THE CEO IS THEN ASSESSED AND EVALUATED ANNUALLY BASED ON GOALS. THE COMMITTEE RESEARCHES INDUSTRY WAGE REPORTS AND ANNUALLY REVIEWS SALARY LEVELS FOR COMPARABILITY. OTHER TOP MANAGEMENT POSITIONS ARE REVIEWED BY BOARD MEMBERS BASED ON ANNUAL GOAL CRITERIA. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE MADE AVAILABLE AT THE OFFICES OF THE ORGANIZATION. PART XI LINE 8 PRIOR PERIOD ADJUSTMENT LISTED REPRESENTS PRIMARILY GRANTS THAT SHOULD HAVE BEEN RECORDED IN PREVIOUS YEARS' UNDER GAAP. THESE GRANTS ARE INCLUDED IN THIS YEAR'S SCHEDULE B AS THEY WERE NOT ON LAST YEAR'S FORM 990.