FORM 1023-EZ for NORTHSTAR HEALTH

Field Data
EIN 85-3916966
Case Number EO-2021085-000324
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTHSTAR HEALTH
Organization’s Mailing Address 995 UNIVERSITY AVE W 202
City SAINT PAUL
State MN
ZIP 55104-4785
Accounting period End 11
Primary contact name CHER VANG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHER VANG
CHIEF EXECUTIVE OFFICER
1501 ETNA STREET
SAINT PAUL MN 55104-1417

Officer/Director/Trustee Two

ABDIRIZAK ALI
CHIEF MEDICAL OFFICER
14272 IRVING AVENUE S 213
BURNSVILLE MN 55306-6114

Organization’s website NORTHSTARHEALTHCENTER.COM
Organization’s email LIAM@NORTHSTARHEALTHCENTER.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/2020
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHER VANG
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 2/2/2021

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