FORM 1023-EZ for MID-SOUTH LIVER ALLIANCE

Field Data
EIN 86-2557406
Case Number EO-2021111-000079
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MID-SOUTH LIVER ALLIANCE
Organization’s Mailing Address 1409 BRENNER COURT
City NASHVILLE
State TN
ZIP 37221
Accounting period End 12
Primary contact name TERESA DAVIDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRIS OUBRE
PRESIDENT
8653 BURKITT DRIVE
NASHVILLE TN 37135

Officer/Director/Trustee Two

JEFF MCILVAIN
SECRETARY/TREASURER
7274 EASTERN AVE
GERMANTOWN TN 38138

Officer/Director/Trustee Three

SOPHOCLIS ALEXOPOULOS MD
VICE PRESIDENT - MAC CHAIR
4307 A IROQUOIS AVE
NASHVILLE TN 37205

Officer/Director/Trustee Four

TERESA DAVIDSON
EXECUTIVE DIRECTOR
1409 BRENNER COURT
NASHVILLE TN 37221

Organization’s website MIDSOUTHLIVERALLIANCE.ORG
Organization’s email MIDSOUTHLIVER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/10/2021
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
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 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 TERESA DAVIDSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 4/17/2021

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