| Field | Data |
|---|---|
| EIN | 82-1498653 |
| Case Number | EO-2018107-000732 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BROOKLYN HEALTH INC |
| Organization’s Mailing Address | 121 DEKALB AVENUE |
| City | BROOKLYN |
| State | NY |
| ZIP | 11201 |
| Accounting period End | 12 |
| Primary contact name | DAVID S MILLER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
CARLOS P NAUDON
CHAIRMAN OF THE BOARD OF TRUSTEES
121 DEKALB AVENUE
BROOKLYN NY 11201
GARY TERRINONI
EX-OFFICIO TRUSTEE, PRES, CEO, CFO
121 DEKALB AVENUE
BROOKLYN NY 11201
ANNE ELIZABETH FONTAINE
SENIOR VICE CHAIR AND TRUSTEE
121 DEKALB AVENUE
BROOKLYN NY 11201
EARL D WEINER
VICE CHAIR AND TRUSTEE
121 DEKALB AVENUE
BROOKLYN NY 11201
CALVIN J SIMONS
VICE CHAIR AND TRUSTEE
121 DEKALB AVENUE
BROOKLYN NY 11201
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/8/16 |
| Organization Incorporation State | NY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E21 - Community Health Systems |
| 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 | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | GARY TERRINONI |
| Signature Title | EX-OFFICIO TRUSTEE, PRES, CEO, CFO |
| Signature Date | 3/29/18 |
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