FORM 1023-EZ for ADAPTIVE CLINICAL EDUCATION SERVICES

Field Data
EIN 85-0578714
Case Number EO-2020139-000572
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADAPTIVE CLINICAL EDUCATION SERVICES
Organization’s Mailing Address 5424 BELL FORGE LANE E UNIT 2116
City ANTIOCH
State TN
ZIP 37011
Accounting period End 12
Primary contact name ELOCHUKWU JUDE EZEKAKPU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELOCHUKWU JUDE EZEKAKPU
PRESIDENT
608 SUGARMILL DR
NASHVILLE TN 37211

Officer/Director/Trustee Two

DOUGLAS STEWART
BOARD MEMBER
924 TODD PREIS DRIVE
NASHVILLE TN 37211

Officer/Director/Trustee Three

ALLISON QUINTANILLA PLATTSMIER
SECRETARY
6829 SUNNYWOOD DRIVE
NASHVILLE TN 37211

Officer/Director/Trustee Four

VICKI HOUSTON
TREASURER
901 JANA DRIVE
SMYRNA TN 37167

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/2020
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
Organization’s purpose Charitable: Yes
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 ELOCHUKWU JUDE EZEKAKPU
Signature Title PRESIDENT
Signature Date 5/16/2020

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