| Field | Data |
|---|---|
| EIN | 47-5399418 |
| Case Number | EO-2015299-000455 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | ELY COMMUNITY HEALTH CENTER |
| Organization’s Mailing Address | 105 EAST CONAN STREET |
| City | ELY |
| State | MN |
| ZIP | 55731 |
| Accounting period End | 12 |
| Primary contact name | MARY BIANCO |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
MARY BIANCO
MD, BOARD CHAIRPERSON
300 WEST CONAN STREET
ELY MN 55731
SARAH KINGSTON
BOARD VICE CHAIRPERSON
13675 DEER ROAD
ELY MN 55731
KRISTINE MOSHER
SECRETARY
13669 MILL ROAD
ELY MN 55731
GAIL GUSTAFSON
TREASURER
2350 BIRCHWOOD LANE
ELY MN 55731
SALLY KOSKI
EXECUTIVE DIRECTOR
105 EAST CONAN STREET
ELY MN 55731
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/16/2015 |
| Organization Incorporation State | MN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E32 - Ambulatory Health Center, Community Clinic |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No 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 | 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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