FORM 1023-EZ for THE EMMADA INSTITUTE OF BEHAVIORALHEALTH AND WELLNESS

Field Data
EIN 81-0894071
Case Number EO-2015358-000146
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE EMMADA INSTITUTE OF BEHAVIORALHEALTH AND WELLNESS
Organization’s Mailing Address 8939 S SEPULVEDA BLVD STE 200
City LOS ANGELES
State CA
ZIP 90045
Accounting period End 12
Primary contact name GLENN MILUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICK WILLIAMSON
PRESIDENT/DIRECTOR
617 N MAR VISTA AVE STE 4
PASADENA CA 91101

Officer/Director/Trustee Two

YOSHADO LANG
DIRECTOR
3520 VAL VERDE AVE
LONG BEACH CA 90808

Officer/Director/Trustee Three

LISA BOLDEN
SECRETARY/DIRECTOR
17638 MAPLE DR
CARSON CA 90746

Officer/Director/Trustee Four

STEVE TARVER
TREASURER/DIRECTOR
4168 GARTHWAITE AVE
LOS ANGELES CA 90008

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2015
Organization Incorporation State CA
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: 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 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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