FORM 1023-EZ for DIVERSIFIED HEALTH AND WELLNESS CARES

Field Data
EIN 83-3428494
Case Number EO-2019164-000352
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIVERSIFIED HEALTH AND WELLNESS CARES
Organization’s Mailing Address 11042 MANCHESTER ROAD
City KIRKWOOD
State MO
ZIP 63122
Accounting period End 12
Primary contact name MARSHA BRADFORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARSHA BRADFORD
PRESIDENT/DIRECTOR
940 BARRETT STATION ROAD
KIRKWOOD MO 63122

Officer/Director/Trustee Two

KURT KOLLER
SECRETARY/TREASURER/DIRECTOR
940 BARRETT STATION ROAD
KIRKWOOD MO 63122

Officer/Director/Trustee Three

JENNA MUELLER
DIRECTOR
7626 ALICIA AVENUE
ST. LOUIS MO 63143

Officer/Director/Trustee Four

TRISH ALEXANDER
DIRECTOR
7513 DEVONSHIRE AVENUE
ST. LOUIS MO 63119

Officer/Director/Trustee Five

STEPHANIE KORPAL
DIRECTOR
6314 S ROSEBURY AVENUE 1E
CLAYTON MO 63105

Organization’s website N/A
Organization’s email DHWCARES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/19
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 Yes
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 MARSHA BRADFORD
Signature Title PRESIDENT/DIRECTOR
Signature Date 6/11/19

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