FORM 1023-EZ for SAFE HAVEN QUALITY CARE

Field Data
EIN 84-4113517
Case Number EO-2020009-000274
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAFE HAVEN QUALITY CARE
Organization’s Mailing Address 2028 BECK STREET
City NEW ORLEANS
State LA
ZIP 70131
Accounting period End 3
Primary contact name JACKIE DUNCAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACKIE MCELVEEN DUNCAN
DIRECTOR
2028 BECK
NEW ORLEANS LA 70131

Officer/Director/Trustee Two

CHRISTINA KADOR
OFFICER
4100 ELDORADO PKWY SUITE 100
MCKINNEY TX 75070

Officer/Director/Trustee Three

DARIO CAREY
OFFICER
3631 RUE MICHELLE
NEW ORLEANS LA 70131

Officer/Director/Trustee Four

JACKIE MIXON
OFFICER
1205 FRANCIS ST
MARRERRO LA 70072

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2020
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical 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 JACKIE MCELVEEN DUNCAN
Signature Title DIRECTOR
Signature Date 1/7/2020

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