FORM 1023-EZ for SOUTHERN PHOENIX PHYSICAL THERAPY AND WELLNESS CENTER INC

Field Data
EIN 84-3619494
Case Number EO-2019316-000173
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHERN PHOENIX PHYSICAL THERAPY AND WELLNESS CENTER INC
Organization’s Mailing Address 82 TURNBULL HILL CT
City SAINT AUGUSTINE
State FL
ZIP 32092
Accounting period End 9
Primary contact name STEPHANIE AUBREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTONIO SOWERS
VICE PRESIDENT
1735 SEMINOLE ROAD
ATLANTIC BEACH FL 32223

Officer/Director/Trustee Two

SAMANTHA BARNES
SECRETARY
8780 BATTEN ROAD
SAINT AUGUSTINE FL 32092

Officer/Director/Trustee Three

ANDREW AUBREY
TREASURER
82 TURNBULL HILL CT
SAINT AUGUSTINE FL 32092

Officer/Director/Trustee Four

STEPHANIE AUBREY
PRESIDENT
82 TURNBULL HILL CT
SAINT AUGUSTINE FL 32092

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/19
Organization Incorporation State FL
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: Yes
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 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 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 STEPHANIE AUBREY
Signature Title PRESIDENT
Signature Date 11/7/19

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