FORM 1023-EZ for MICHIGAN MENTAL HEALTH PROVIDERS ASSOCIATION

Field Data
EIN 83-1282533
Case Number EO-2018227-000218
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MICHIGAN MENTAL HEALTH PROVIDERS ASSOCIATION
Organization’s Mailing Address 866 RIVER BEND DR
City ROCHESTER HILLS
State MI
ZIP 48308
Accounting period End 6
Primary contact name THERESA MIKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NAPOLEON HARRINGTON
PRESIDENT
2510 ARMADA DR
AUBURN HILLS MI 48326

Officer/Director/Trustee Two

JAMES BLUNDO
EXECUTIVE DIRECTOR
866 RIVER BEND DR
ROCHESTER HILLS MI 48307

Officer/Director/Trustee Three

AMY ROMANO
SECRETARY
22677 BRETINGHAM
MACOMB MI 48044

Officer/Director/Trustee Four

RAELEEN DAVIS
TREASURER
4095 BOLD MEADOW
OAKLAND TWP MI 48306

Officer/Director/Trustee Five

THERESA MIKE
ACCOUNTANT
1409 N PINE ST
ROCHESTER HILLS MI 48307

Organization’s website
Organization’s email TMIKE9968@ATT.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
Organization’s purpose Charitable: No
Religious: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAMES BLUNDO
Signature Title EXECUTIVE DIRECTOR
Signature Date 8/13/18

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