FORM 1023-EZ for THE HEALING WELL

Field Data
EIN 81-5049738
Case Number EO-2017079-000323
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE HEALING WELL
Organization’s Mailing Address 718 J CLYDE MORRIS BLVD
City NEWPORT NEWS
State VA
ZIP 23601-1540
Accounting period End 12
Primary contact name JENNIFER DATTILO WATTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID FLY
PRESIDENT
2901 RICHARD BUCK SOUTH
WILLIAMSBURG VA 23185-8303

Officer/Director/Trustee Two

PAULA TISDALE
VICE PRESIDENT
102 WOOD LAKE TERRACE
SUFFOLK VA 23434-2037

Officer/Director/Trustee Three

JENNIFER DATTILO WATTS
SECRETARY
120 LONG BRIDGE RD
HAMPTON VA 23669-2021

Officer/Director/Trustee Four

SARAH LAWS
TREASURER
3909 FORRESTHILLS DR
PORTSMOUTH VA 23703-3444

Officer/Director/Trustee Five

KRISTEN FLY
TRUSTEE
2901 RICHARD BUCK SOUTH
WILLAMSBURG VA 23185-8303

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2017
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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