FORM 1023-EZ for BREVARD BEHAVIORAL ASSOCIATES
| Field | Data |
|---|---|
| EIN | 87-1155461 |
| Case Number | EO-2021165-000604 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BREVARD BEHAVIORAL ASSOCIATES |
| Organization’s Mailing Address | 915 LYTTON RD |
| City | MELBOURNE |
| State | FL |
| ZIP | 32934 |
| Accounting period End | 12 |
| Primary contact name | TINA SMITH |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
NICHOLAS SCHULTZ
DIRECTOR
915 LYTTON RD
MELBOURNE FL 32934
Officer/Director/Trustee Two
GEORGINA OLSEN
ASST DIRECTOR
125 TEQUESTA HARBOR DRIVE
MERRITT ISLAND FL 32952
Officer/Director/Trustee Three
TINA SMITH
ASST DIRECTOR
1410 ISABELLA DRIVE BOX 105
MELBOURNE FL 32935
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/18/2021 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | V23 - Behavioral Science |
| Organization’s purpose | Charitable: No Religious: No 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 | 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 | 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 | TINA SMITH |
| Signature Title | ASST DIRECTOR |
| Signature Date | 6/11/2021 |
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