FORM 1023-EZ for THE WELLSTONE HEALING CENTER

Field Data
EIN 86-2598166
Case Number EO-2021099-001883
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE WELLSTONE HEALING CENTER
Organization’s Mailing Address 1801 BUSH ST SUITE 209
City SAN FRANCISCO
State CA
ZIP 94109
Accounting period End 12
Primary contact name PAUL RESNIKOFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELENA GOMEZ
CEO
1801 BUSH ST SUITE 209
SAN FRANCISCO CA 94109

Officer/Director/Trustee Two

KATELYN HUENING
SECRETARY
1801 BUSH ST SUITE 209
SAN FRANCISCO CA 94109

Officer/Director/Trustee Three

LANCE MILLS
CFO
1801 BUSH ST SUITE 209
SAN FRANCISCO CA 94109

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 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 ELENA GOMEZ
Signature Title CEO
Signature Date 3/22/2021

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