FORM 1023-EZ for PRIORITY CARE

Field Data
EIN 47-4967030
Case Number EO-2020021-000425
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PRIORITY CARE
Organization’s Mailing Address 530 LAKELAND DRIVE
City BATON ROUGE
State LA
ZIP 70802
Accounting period End 12
Primary contact name CHANTEL CROCKETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANTEL CROCKETT
PRESIDENT
2376 CREEK HOLLOW AVE
ZACHARY LA 70791

Officer/Director/Trustee Two

SHANTEL ANTHONY
CHAIRPERSON
10635 BLACK OAK DRIVE
BATON ROUGE LA 70815

Officer/Director/Trustee Three

BRITTANY DIXON
TREASURER
1003 GEORGIA BLUE DRIVE
RICHMOND TX 77406

Officer/Director/Trustee Four

TERIKA WHITE
SECRETARY
5671 HARTFORD AVE
BATON ROUGE LA 70812

Officer/Director/Trustee Five

KIMBERLY WALKER
OFFICER
6241 MORNING DOVE DRIVE
BATON ROUGE LA 70817

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/2015
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: No
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHANTEL CROCKETT
Signature Title PRESIDENT
Signature Date 1/16/2020

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