FORM 1023-EZ for INTENTIONAL MENTAL HEALTH
| Field | Data |
|---|---|
| EIN | 85-3252733 |
| Case Number | EO-2021189-000043 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | INTENTIONAL MENTAL HEALTH |
| Organization’s Mailing Address | 1840 SOUTH ELENA AVENUE 106 |
| City | REDONDO BEACH |
| State | CA |
| ZIP | 90277-5716 |
| Accounting period End | 12 |
| Primary contact name | KIM NICOLSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KIMBERLY NICOLSON
PRESIDENT
1840 SOUTH ELENA AVENUE 106
REDONDO BEACH CA 90277-5716
Officer/Director/Trustee Two
SCOTT KAYE
RECORDING SECRETARY
21515 HAWTHORNE BOULEVARD
TORRANCE CA 90503-6512
Officer/Director/Trustee Three
PAUL KOLIANDER
TREASURER
1334 PARK VIEW AVENUE
MANHATTAN BEACH CA 90266-3725
Officer/Director/Trustee Four
DHIRAJ RAMIREDDY
DIRECTOR
3644 DEL AMO BOULEVARD APARTMENT B
TORRANCE CA 90503-1620
Officer/Director/Trustee Five
MICHELLE TANGEMAN
DIRECTOR
28649 SOUTH WESTERN AVENUE 6516
SAN PEDRO CA 90734-6516
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/4/2020 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O50 - Youth Development Programs, Other |
| 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 | 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 | KIMBERLY NICOLSON |
| Signature Title | PRESIDENT |
| Signature Date | 7/3/2021 |
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