FORM 1023-EZ for KIDNEY DISEASE SCREENING AND AWARENESS PROGRAM
| Field | Data |
|---|---|
| EIN | 27-1105580 |
| Case Number | EO-2021140-000506 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | KIDNEY DISEASE SCREENING AND AWARENESS PROGRAM |
| Organization’s Mailing Address | 221 LONGWOOD AVENUE BLI ROOM 449 |
| City | BOSTON |
| State | MA |
| ZIP | 02115-6110 |
| Accounting period End | 12 |
| Primary contact name | PRESIDENT ANDREW ROSENBLATT |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ANDREW ROSENBLATT
PRESIDENT
22981 BARTOLOME
MISSION VIEJO CA 92692-1400
Officer/Director/Trustee Two
JEREMY POLICHT
VICE PRESIDENT
1141 N VIRGIL AVE
LOS ANGELES CA 90029-2015
Officer/Director/Trustee Three
LILI HSIAO
PHYSICIAN ADVISOR
815 CENTRE STREET APT 2
BOSTON MA 02130-2735
Officer/Director/Trustee Four
JANE KUO
OPERATIONS OFFICER
41 AVENUE LOUIS PASTEUR AH 120
BOSTON MA 02115-6110
| Organization’s website | KDSAP.ORG |
|---|---|
| Organization’s email | CONTACT@KDSAP.ORG |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/15/2008 |
| Organization Incorporation State | MA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E70 - Public Health Program (Includes General Health and Wellness Promotion 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 | 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 | ANDREW ROSENBLATT |
| Signature Title | PRESIDENT |
| Signature Date | 5/14/2021 |
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