FORM 1023-EZ for PROVIDERS ASSOCIATION FOR HOME HEALTH HOSPICE AGENCIES INC

Field Data
EIN 45-2119719
Case Number EO-2015307-000098
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROVIDERS ASSOCIATION FOR HOME HEALTH HOSPICE AGENCIES INC
Organization’s Mailing Address 2695 VILLA CREEK DR STE 147
City DALLAS
State TX
ZIP 75234-7371
Accounting period End 12
Primary contact name LINDA GRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOSEPHINE DEVADOSS
PRESIDENT
3011 OXFORDSHIRE
DALLAS TX 75234

Officer/Director/Trustee Two

KELLY COLLINS
SECRETARY
7 SURREY COURT
RANCHERS MIRAGE CA 92270

Officer/Director/Trustee Three

JEROME DEVADOSS
TREASURER
3011 OXFORDSHIRE LN
DALLAS TX 75234

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2011
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P44 - Homemaker, Home Health Aide
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 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 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
Signature Title
Signature Date

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