FORM 1023-EZ for THE NIGHTINGALE HOME INC
| Field | Data |
|---|---|
| EIN | 83-4336719 |
| Case Number | EO-2019266-000313 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE NIGHTINGALE HOME INC |
| Organization’s Mailing Address | PO BOX 25 |
| City | POUNDING MILL |
| State | VA |
| ZIP | 24637 |
| Accounting period End | 12 |
| Primary contact name | REGINA ROBERTS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
REGINA ROBERTS
PRESIDENT
261 COVE ROAD
TAZEWELL VA 24651
Officer/Director/Trustee Two
AARON ROBERTS
DIRECTOR
261 COVE ROAD
TAZEWELL VA 24651
Officer/Director/Trustee Three
RACHEL ROBERTS
SECRETARY
261 COVE ROAD
TAZEWELL VA 24651
Officer/Director/Trustee Four
MARK MULLINS
DIRECTOR
1725 BAPTIST VALLEY ROAD
CEDAR BLUFF VA 24609
Officer/Director/Trustee Five
DAVID LEE HORTON
DIRECTOR
528 SYCAMORE LANE
RICHLANDS VA 24641
| Organization’s website | N/A |
|---|---|
| Organization’s email | NIGHTINGALEHOME18@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/27/19 |
| Organization Incorporation State | VA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P80 - Services to Promote the Independence of Specific Populations |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | REGINA ROBERTS |
| Signature Title | PRESIDENT |
| Signature Date | 9/19/19 |
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