FORM 1023-EZ for CROSSROADS RECOVERY HOUSE
| Field | Data |
|---|---|
| EIN | 82-2967475 |
| Case Number | EO-2017307-000214 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CROSSROADS RECOVERY HOUSE |
| Organization’s Mailing Address | 36063 RALEIGH DRIVE |
| City | DENHAM SPRINGS |
| State | LA |
| ZIP | 70706 |
| Accounting period End | 12 |
| Primary contact name | RENE LEBLANC |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
RENE LEBLANC
ADMINISTRATIVE DIRECTOR
36063 RALEIGH DR
DENHAM SPRINGS LA 70706
Officer/Director/Trustee Two
ROBERT MAXIE
CLINICAL DIRECTOR
1313 TAMARI DRIVE
BATON ROUGE LA 70815
Officer/Director/Trustee Three
JIM ALISE
TREASURER
12390 ONEAL ROAD
GONZALES LA 70737
Officer/Director/Trustee Four
RENA LEBLANC
SECRETARY
36063 RALEIGH DRIVE
DENHAM SPRINGS LA 70706
Officer/Director/Trustee Five
LUKE THIBODEAUX
OFFICER
10143 GLEN RIDGE AVE
BATON ROUGE LA 70808
| Organization’s website | CROSSROADSBR.ORG |
|---|---|
| Organization’s email | INFO@CROSSROADSBR.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/4/2017 |
| Organization Incorporation State | LA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F22 - Alcohol, Drug Abuse, Treatment Only |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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