| Field | Data |
|---|---|
| EIN | 47-2554176 |
| Case Number | EO-2014356-000377 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | ADULT DISABILITY MEDICAL HOME INC |
| Organization’s Mailing Address | PO BOX 88534 |
| City | ATLANTA |
| State | GA |
| ZIP | 30356 |
| Accounting period End | 12 |
| Primary contact name | JEFFREY REZNIK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
JEFFREY REZNIK
PRESIDENT, DIRECTOR
2520 WINDY HILL RD STE 303
MARIETTA GA 30067
ANDREA VIDELEFSKY
VICE PRESIDENT, SECRETARY, DIRECTOR
2520 WINDY HILL RD STE 303
MARIETTA GA 30067
EMILY GILCREAST
TREASURER, DIRECTOR
475 KENBROOK DR NW
ATLANTA GA 30327
| Organization’s website | N/A |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/12/2014 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes 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 | No |
| Donation of funds | No |
| Conducting Activities Outside of United States | No |
| 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 | |
| Signature Title | |
| Signature Date |
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