| Field | Data |
|---|---|
| EIN | 81-0810970 |
| Case Number | EO-2016201-000207 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | HEARTSPACE CLINIC |
| Organization’s Mailing Address | 201 W BROADWAY BLDG 2 STE F |
| City | COLUMBIA |
| State | MO |
| ZIP | 65203 |
| Accounting period End | 12 |
| Primary contact name | CLARENCE E JETT CPA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
CHRIS LAWRENCE
PSYCHOLOGIST
4170 ROEMER ROAD
COLUMBIA MO 65202
KIM OLIVER
SOCIAL WORKER
4170 ROEMER ROAD
COLUMBIA MO 65202
MISTY BUSH
SOCIAL WORKER
1307 SUBELLA
COLUMBIA MO 65203
LAURA WACKER
MEMBER
201 W BROADWAY BLD2 STEF
COLUMBIA MO 65203
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/25/2015 |
| Organization Incorporation State | MO |
| 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: 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 | 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 | |
| Signature Title | |
| Signature Date |
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