FORM 1023-EZ for THE NORTHWEST COMMUNITY HEALTH ALLIANCE

Field Data
EIN 83-4328386
Case Number EO-2019100-000233
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE NORTHWEST COMMUNITY HEALTH ALLIANCE
Organization’s Mailing Address 409 NORTH ROSEMARY AVENUE
City WEST PALM BEACH
State FL
ZIP 33401-4133
Accounting period End 12
Primary contact name PHILLIP HUTCHINSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RONALD DAVIS
CHAIRMAN
500 SOUTH AUSTRALIAN AVENUE
WEST PALM BEACH FL 33401

Officer/Director/Trustee Two

GERALD KISNER
VICE-CHAIRMAN
801 8TH STREET
WEST PALM BEACH FL 33401-3607

Officer/Director/Trustee Three

CYNTHIA WARE
DIRECTOR
1500 39TH STREET
WEST PALM BEACH FL 33407-3632

Officer/Director/Trustee Four

MARIE JOACHIN
DIRECTOR
2000 NORTH CONGRESS AVENUE
WEST PALM BEACH FL 33409-6330

Officer/Director/Trustee Five

PHILLIP HUTCHINSON
DIRECTOR
777 SOUTH FLAGLER DRIVE
WEST PALM BEACH FL 33401

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/16
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
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 PHILLIP HUTCHINSON
Signature Title DIRECTOR
Signature Date 4/8/19

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