| Field | Data |
|---|---|
| EIN | 84-5111847 |
| Case Number | EO-2020139-000235 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | CHRYSALLIS WELLNESS CENTER INC |
| Organization’s Mailing Address | 11932 FAIRWAY LAKES DRIVE |
| City | FORT MYERS |
| State | FL |
| ZIP | 33913 |
| Accounting period End | 12 |
| Primary contact name | ODENI MORENO |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
SCARLETT OLIVARES
PRESIDENT
9735 BLUE STONE CIRCLE
FORT MYERS FL 33913
MARIE BOISBEL
VICE PRESIDENT
2189 BERKLEY WAY
LEHIGH ACRES FL 33973
GLENDA MEDINA
TREASURER
519 FLETCHER STREET
PORT CHARLOTTE FL 33954
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/13/2020 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F30 - Mental Health Treatment - Multipurpose and N.E.C. |
| 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 | 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | SCARLETT OLIVARES |
| Signature Title | PRESIDENT |
| Signature Date | 5/14/2020 |
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