STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

HOPEWELL HEALTH CENTERS INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HOPEWELL HEALTH CENTERS INC (EIN 31-1155352)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-13
IRS object ID
202043219349310824
Schema version
2019v5.0
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)
Return2020-11-13T15:32:18-07:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311155352EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOPEWELL HEALTH CENTERS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOPEBusinessNameControlTxt
Phone7407731006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 188AddressLine1Txt
CityChillicotheCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJames MorrisPersonNm
Person TitleDir of Fiscal ServicesPersonTitleTxt
Phone7405945045PhoneNum
Signature2020-11-13SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address8.21.121.10IPv4AddressTxt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMark BridenbaughPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 188AddressLine1Txt
CityChillicotheCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$66,800,256GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionProvide access to affordable high quality healthcare without discrimination to the residents of southeast Ohio.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee911TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$8,568,431PYContributionsGrantsAmt
CY Contributions Grants$8,311,895CYContributionsGrantsAmt
PY Program Service Revenue$40,949,984PYProgramServiceRevenueAmt
CY Program Service Revenue$48,078,970CYProgramServiceRevenueAmt
PY Investment Income$3,023PYInvestmentIncomeAmt
CY Investment Income$1,892CYInvestmentIncomeAmt
PY Other Revenue$8,350,140PYOtherRevenueAmt
CY Other Revenue$10,339,767CYOtherRevenueAmt
PY Total Revenue$57,871,578PYTotalRevenueAmt
CY Total Revenue$66,732,524CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$38,923,038PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$44,107,808CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$16,465,249PYOtherExpensesAmt
CY Other Expenses$16,729,450CYOtherExpensesAmt
PY Total Expenses$55,388,287PYTotalExpensesAmt
CY Total Expenses$60,837,258CYTotalExpensesAmt
PY Revenues Less Expenses$2,483,291PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,895,266CYRevenuesLessExpensesAmt
Total Assets BOY$22,206,440TotalAssetsBOYAmt
Total Assets EOY$28,242,400TotalAssetsEOYAmt
Total Liabilities BOY$8,289,860TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,430,554TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,916,580NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,811,846NetAssetsOrFundBalancesEOYAmt
MissionProvide access to high quality health, dental, mental health services without discrimination to the residents of southeastern Ohio.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$23,565,268ExpenseAmt
Grant$0GrantAmt
Revenue$39,035,912RevenueAmt
DescProvide medical and dental services to rural southern Ohio. Serving Ross, Perry, Hocking, Vinton, Athens, Gallia, Jackson, and Meigs counties.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$30,779,562ExpenseAmt
Grant$0GrantAmt
Revenue$27,200,178RevenueAmt
DescProvide mental health, counseling, and addiction treatment services to rural southern Ohio. Serving Ross, Perry, Athens, Hocking, Vinton, Washington, Meigs, and Jackson counties.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$487,505ExpenseAmt
Grant$0GrantAmt
Revenue$496,434RevenueAmt
DescWIC - Women, Infants and Children nutritional program that helps women, new mothers, and young children eat healthy and stay healthy. Serving Athens and Perry counties.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$54,832,335TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document27IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee911EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBrad NelsonPersonNm
Phone7407731006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 188AddressLine1Txt
CityChillicotheCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Brittane Britton
Dentist400Yes (X)$403,572$0$11,200
Nicholas Gatzulis
Dentist400Yes (X)$398,815$0$11,200
Damodar Poudel
Regional Medical Director400$285,163$0$11,200Yes (X)
Mary Hanessian
Director of Psychiatry400$280,570$0$11,200Yes (X)
Shivaprakash Kudlapur
Physician400Yes (X)$264,919$0$9,279
Benjamin Jordan
Psychiatrist400Yes (X)$262,473$0$10,380
Sanju Mahato
Physician400Yes (X)$249,531$0$9,818
Douglas Carr
Regional Medical Director400$235,100$0$9,340Yes (X)
Eduardo Robles
Chief Medical Officer400$227,631$0$8,969Yes (X)
Darcy Cook
Director of Dentistry400$200,595$0$7,605Yes (X)
Mark Bridenbaugh
Chief Executive Officer400$194,599$0$7,643Yes (X)
Robert Yoho
Director of Pharmacology400$133,984$0$3,746Yes (X)
Sherry Shamblin
Chief Stategy Officer400$121,827$0$4,746Yes (X)
David Schenkelberg
Chief Clinical Officer400$120,813$0$4,673Yes (X)
Bradford Nelson
Chief Financial Officer400$120,458$0$4,771Yes (X)
Kathy Cecil
Board President00$0$0$0Yes (X)
Don Poole
Board Vice-President00$0$0$0Yes (X)
John Means
Board Treasurer00$0$0$0Yes (X)
Tom McGuire
Board Member00$0$0$0Yes (X)
Margaret Hill-Daniels
Board Member00$0$0$0Yes (X)
Martha Murphy
Board Member00$0$0$0Yes (X)
Amy Jo Newlun
Board Member00$0$0$0Yes (X)
Jennifer Holt-Hill
Board Member00$0$0$0Yes (X)
Daniel Brown
Board Member00$0$0$0Yes (X)
Gregory Ervin
Board Member00$0$0$0Yes (X)
Peter Howison MD
Board Member00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,500,050TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$125,770TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K57IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
Eclinical Works LLC
PO Box 847950BostonMA02284Electronic Medical Records$599,196
RxStrategies
1900 Glades RdBoca RotonFL33431340B Pharmacy Processing$543,088Suite 350
Trizetto
Dept CH 16897PalatineIL60055Claims Processing$335,372
Patterson Dental Supply Inc
PO Box 28244ChicagoIL60673Dental Equipment Supplier$782,818
Natural Freedom
41810 State Farm RoadAlbanyOH45710Contracted Service Provider$214,069
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K34CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$8,311,895GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$8,311,895TotalContributionsAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,078,970TotalRevenueColumnAmt
Related Or Exempt Func Income$48,078,970RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$48,078,970TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,342TotalRevenueColumnAmt
Related Or Exempt Func Income$1,342RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$29,608RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$29,608RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,608TotalRevenueColumnAmt
Related Or Exempt Func Income$29,608RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$68,282OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$67,732OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$550OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$550TotalRevenueColumnAmt
Related Or Exempt Func Income$550RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
340B Program900099$10,257,677$10,257,677$0$0
Medical Records900099$44,821$44,821$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,661TotalRevenueColumnAmt
Related Or Exempt Func Income$7,661RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$10,310,159OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$66,732,524TotalRevenueColumnAmt
Related Or Exempt Func Income$58,420,629RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,865,078TotalAmt
Program Services$31,440,302ProgramServicesAmt
Management And General$2,424,776ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$803,136TotalAmt
Program Services$722,309ProgramServicesAmt
Management And General$80,827ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,968,411TotalAmt
Program Services$5,795,844ProgramServicesAmt
Management And General$1,172,567ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,471,183TotalAmt
Program Services$2,309,011ProgramServicesAmt
Management And General$162,172ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,156,546TotalAmt
Program Services$1,459,376ProgramServicesAmt
Management And General$697,170ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,896TotalAmt
Program Services$3,856ProgramServicesAmt
Management And General$1,040ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,910TotalAmt
Program Services$7,600ProgramServicesAmt
Management And General$17,310ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$153,974TotalAmt
Program Services$90,926ProgramServicesAmt
Management And General$63,048ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,091,123TotalAmt
Program Services$5,475,973ProgramServicesAmt
Management And General$615,150ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$284,652TotalAmt
Program Services$50,917ProgramServicesAmt
Management And General$233,735ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,811,758TotalAmt
Program Services$1,809,237ProgramServicesAmt
Management And General$2,521ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$874,376TotalAmt
Program Services$837,350ProgramServicesAmt
Management And General$37,026ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$228,334TotalAmt
Program Services$181,234ProgramServicesAmt
Management And General$47,100ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$195,100TotalAmt
Program Services$180,472ProgramServicesAmt
Management And General$14,628ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$133,322TotalAmt
Program Services$80,027ProgramServicesAmt
Management And General$53,295ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$737,686TotalAmt
Program Services$444,705ProgramServicesAmt
Management And General$292,981ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$105,379TotalAmt
Program Services$15,802ProgramServicesAmt
Management And General$89,577ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
340B Program$3,707,922$3,707,922$0$0
Vehicle Maintenance$30,193$30,193$0$0
Vehicle Lease$136,282$136,282$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$52,997TotalAmt
Program Services$52,997ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$60,837,258TotalAmt
Program Services$54,832,335ProgramServicesAmt
Management And General$6,004,923ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,182BOYAmt
EOY$6,772EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,169,371BOYAmt
EOY$7,298,043EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,034,730BOYAmt
EOY$8,632,536EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$75,070BOYAmt
EOY$105,503EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,655,141LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,636,125LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,901,979BOYAmt
EOY$12,019,016EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$19,108BOYAmt
EOY$180,530EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$22,206,440BOYAmt
EOY$28,242,400EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,830,229BOYAmt
EOY$4,265,401EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,459,631BOYAmt
EOY$4,165,153EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,289,860BOYAmt
EOY$8,430,554EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,227,580BOYAmt
EOY$19,811,846EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$689,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,916,580BOYAmt
EOY$19,811,846EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,206,440BOYAmt
EOY$28,242,400EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,895,266ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$19,108BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$1,342InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$20,450EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,476BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$2,632InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$19,108EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,476BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,476EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,476BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,476EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,011BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$465InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,476EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,017,183InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Book Value$1,017,183BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$12,210,023InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$2,982,943DepreciationAmt
Book Value$9,227,080BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$947,212InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$392,706DepreciationAmt
Book Value$554,506BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$3,480,723InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$2,260,476DepreciationAmt
Book Value$1,220,247BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,019,016TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$66,732,524TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$0NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants$0RecoveriesPriorYearGrantsAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$66,732,524RevenueSubtotalAmt
Investment Expenses Not Incld$0InvestmentExpensesNotIncldAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$66,732,524TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$60,837,258TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$0DonatedServicesUseFcltsAmt
Prior Year Adjustments$0PriorYearAdjustmentsAmt
Losses Reported$0LossesReportedAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$60,837,258ExpensesSubtotalAmt
Investment Expenses Not Incld2$0InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$60,837,258TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part V, Line 4FormAndLineReferenceDesc
ExplanationEndowment fund established to help defray costs associated with uninsured patients.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Eduardo Robles
Chief Medical Officer$227,631$0$0$0$0$0$8,969$0$0$0$236,600$0$0$0
Mark Bridenbaugh
Chief Executive Officer$194,599$0$0$0$0$0$7,643$0$0$0$202,242$0$0$0
Damodar Poudel
Regional Medical Director$285,163$0$0$0$0$0$11,200$0$0$0$296,363$0$0$0
Mary Hanessian
Director of Psychiatry$235,100$0$0$0$0$0$9,340$0$0$0$244,440$0$0$0
Douglas Carr
Regional Medical Director$235,100$0$0$0$0$0$9,340$0$0$0$244,440$0$0$0
Darcy Cook
Director of Dentistry$200,595$0$0$0$0$0$7,605$0$0$0$208,200$0$0$0
Brittane Britton
Dentist$403,572$0$0$0$0$0$11,200$0$0$0$414,772$0$0$0
Nicholas Gatzulis
Dentist$398,815$0$0$0$0$0$11,200$0$0$0$410,015$0$0$0
Shivaprakash Kudlapur
Physician$264,919$0$0$0$0$0$9,279$0$0$0$274,198$0$0$0
Benjamin Jordan
Psychiatrist$262,473$0$0$0$0$0$10,380$0$0$0$272,853$0$0$0
Sanju Mahato
Physician$249,531$0$0$0$0$0$9,818$0$0$0$259,349$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11bThe form 990 is provided to the board members for review prior to submission.
Form 990, Part VI, Section B, Line 12cBoard members are required to complete a questionnaire.
Form 990, Part VI, Section B, Line 15The Board of Directors approves all pay scale and cost of living increases for the year. A review of comparable health centers and salaries in the community are reviewed when making any changes to pay scales.
Form 990, Part VI, Section C, Line 19Information in the organization's governing documents, conflict of interest policy and financial statements are made available upon request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Tri-County Mental Health & Counseling Services IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line190 Hospital DriveAddressLine1Txt
CityAthensCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45701ZIPCd
FieldValueIRS element (for citing)
EIN310860366EIN
Primary ActivitiesBehavioral Health CarePrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity Status7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Hopewell Health Centers IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationSubmitted Form 8868 for automatic 6-month extension. Extension accepted on 03/19/2020 extending due date until 11/15/2020.ExplanationTxt