| Field | Data |
|---|---|
| EIN | 82-5412489 |
| Case Number | EO-2018150-000259 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | LA SELVA WELLNESS |
| Organization’s Mailing Address | 3065 ROSECRANS PL STE 104 |
| City | SAN DIEGO |
| State | CA |
| ZIP | 92110 |
| Accounting period End | 12 |
| Primary contact name | HEIDI BROCKMYRE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
HEIDI BROCKMYRE
DIRECTOR AND PRESIDENT
2835 WORDEN ST
SAN DIEGO CA 92110
KRISTYN CAETANO
DIRECTOR AND TREASURER
7090 NERI DR
LA MESA CA 91942
REBECCA BERGGREN
DIRECTOR AND SECRETARY
4259 ORCHARD AVE
SAN DIEGO CA 92107
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/12/18 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E50 - Rehabilitative Medical 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 | 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 | HEIDI BROCKMYRE |
| Signature Title | DIRECTOR AND PRESIDENT |
| Signature Date | 5/25/18 |
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