| Field | Data |
|---|---|
| EIN | 87-2336936 |
| Case Number | EO-2021242-000193 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | FAMILY & LIFESTYLE MEDICINE |
| Organization’s Mailing Address | PO BOX 91 |
| City | GRAND LEDGE |
| State | MI |
| ZIP | 48837 |
| Accounting period End | 6 |
| Primary contact name | KIMBERLY R AZELTON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
KIMBERLY AZELTON
SECRETARY
12911 KELLY LN
GRAND LEDGE MI 48837
PHIL MILLS
CHAIR
1117 SCOUT LN
HIXSON TN 37343
TOM OWITI
BOARD MEMBER
6150 W MICHIGAN AVE APT M22
LANSING MI 48917
JUSTIN RINGSTAFF
BOARD MEMBER
12108 MADONNA DR
LANSING MI 48917
PHILIP MILLS
BOARD MEMBER
10232 N ROYSTON RD
GRAND LEDGE MI 48837
| Organization’s website | FAMILYANDLIFESTYLEMEDICINE.ORG |
|---|---|
| Organization’s email | INFO@FAMILYANDLIFESTYLEMEDICINE.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/13/2021 |
| Organization Incorporation State | MI |
| Contains Limitation | No |
| Does not expressly empower | No |
| Contains dissolution | No |
| National Taxonomy of Exempt Entities (NTEE) code | E30 - Health Treatment Facilities, Primarily Outpatient |
| Organization’s purpose | Charitable: Yes Religious: Yes Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | Yes |
| Legislation influence | No |
| Compensation of Officer director trustee | Yes |
| Donation of funds | Yes |
| 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 | No |
| Signature Name | KIMBERLY AZELTON |
| Signature Title | SECRETARY |
| Signature Date | 8/26/2021 |
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