FORM 1023-EZ for BRIDGE TO HEALTH NM

Field Data
EIN 86-2703121
Case Number EO-2021099-001080
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRIDGE TO HEALTH NM
Organization’s Mailing Address 33A THANPI TSIDE POE
City SANTA FE
State NM
ZIP 87506
Accounting period End 6
Primary contact name TANA BEVERWYK-ABOUDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TANA BEVERWYK-ABOUDA
EXECUTIVE DIRECTOR
33A THANPI TSIDE POE
SANTA FE NM 87506-7101

Officer/Director/Trustee Two

MARY PARSACA
SECRETARY
PO BOX 747
VELARDE NM 87582-0661

Officer/Director/Trustee Three

MELISSA SALAZAR
TREASURER
PO BOX 1097
OHKAY OWINGEH NM 87566-1011

Officer/Director/Trustee Four

CHERYL MARITA
BOARD MEMBER
80A COUNTY ROAD 122
ESPANOLA NM 87532-3281

Officer/Director/Trustee Five

SELENA VALENCIA
BOARD MEMBER
828 VISTA POINTE
SANTA CRUZ NM 87567-6753

Organization’s website BRIDGETOHEALTHNM.ORG
Organization’s email BRIDGETOHEALTHNM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/9/2021
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 TANA BEVERWYK-ABOUDA
Signature Title EXECUTIVE DIRECTOR
Signature Date 3/18/2021

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