| Field | Data |
|---|---|
| EIN | 86-1923003 |
| Case Number | EO-2021099-000440 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | CRISIS MENTAL HEALTH OUTREACH INCORPORATED |
| Organization’s Mailing Address | 510 VICTORIA PLACE A4 |
| City | THOMASVILLE |
| State | GA |
| ZIP | 31792 |
| Accounting period End | 12 |
| Primary contact name | DR COURTNEY KELLEIGH MD MHS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
DR COURTNEY KELLEIGH
CEO PRESIDENT
510 VICTORIA PLACE
THOMASVILLE GA 31792
PENINA IVEY
TREASURER
614 WEST CLAY STREET
THOMASVILLE GA 31792
CHRISTOPHER SHEFFIELD
SECRETARY
609 EAST CLAY STREET
THOMASVILLE GA 31792
| Organization’s website | CRISIS-OUTREACH.ORG |
|---|---|
| Organization’s email | INFO@CRISIS-OUTREACH.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/27/2021 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F40 - Hot Line, Crisis Intervention 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 | Yes |
| 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 | DR COURTNEY KELLEIGH |
| Signature Title | CEO PRESIDENT |
| Signature Date | 3/19/2021 |
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