FORM 1023-EZ for BEHAVIORAL HEALTH COLLABORATIVE INC

Field Data
EIN 61-1737054
Case Number EO-2016201-000385
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BEHAVIORAL HEALTH COLLABORATIVE INC
Organization’s Mailing Address 47 INMAN STREET APT 12
City CAMBRIDGE
State MA
ZIP 02139-1734
Accounting period End 6
Primary contact name J BENJAMIN HARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

J BENJAMIN HARRIS
PRESIDENT, DIRECTOR
47 INMAN STREET APT 12
CAMBRIDGE MA 02139-1734

Officer/Director/Trustee Two

DUANE BROWN
TREASURER, DIRECTOR
114 PINE STREET
CAMBRIDGE MA 02139-2722

Officer/Director/Trustee Three

CHRISTINE HICKEY
CLERK, DIRECTOR
91 BUCKNAM STREET
EVERETT MA 02149-2140

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2004
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J20 - Employment Procurement Assistance, Job Training
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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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