FORM 1023-EZ for NORTH BATON ROUGE CANCER CENTER

Field Data
EIN 83-2038753
Case Number EO-2019063-000416
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH BATON ROUGE CANCER CENTER
Organization’s Mailing Address 4811 HARDING BLVD
City BATON ROUGE
State LA
ZIP 70811
Accounting period End 12
Primary contact name CAMERON MONROE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAMERON MONROE
DIRECTOR
4811 HARDING BLVD
BATON ROUGE LA 70811

Officer/Director/Trustee Two

MARTHA WILLIAMS
BOARD MEMBER
661 W 71ST STREET
SHREVEPORT LA 71106

Officer/Director/Trustee Three

ANNA JONES
BOARD MEMBER
4811 HARDING BLVD
BATON ROUGE LA 70811

Organization’s website
Organization’s email ICARE2027@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/19
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E21 - Community Health Systems
Organization’s purpose Charitable: No
Religious: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CAMERON MONROE
Signature Title DIRECTOR
Signature Date 3/1/19

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