FORM 1023-EZ for COMMUNITY HEALTH NETWORK OF KENTUCKY
| Field | Data |
|---|---|
| EIN | 85-4033631 |
| Case Number | EO-2021020-000082 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY HEALTH NETWORK OF KENTUCKY |
| Organization’s Mailing Address | 380 SUWANNEE TRAIL STREET |
| City | BOWLING GREEN |
| State | KY |
| ZIP | 42103 |
| Accounting period End | 6 |
| Primary contact name | JOE DAN BEAVERS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JOE DAN BEAVERS
DIRECTOR
380 SUWANNEE TRAIL STREET
BOWLING GREEN KY 42103
Officer/Director/Trustee Two
ERIC EMBRY
BOARD MEMBER
3999 FT CAMPBELL BLVD
HOPKINSVILLE KY 42240
Officer/Director/Trustee Three
TERRY HUDSPETH
BOARD MEMBER
425 BROADWAY STREET
PADUCAH KY 42001
Officer/Director/Trustee Four
MELANIE YEAGER
BOARD MEMBER
1203 AMERICAN GREETING CARD RD
CORBIN KY 40701
Officer/Director/Trustee Five
DAN SIMPSON
BOARD MEMBER
107 CRANES ROOST CT
ELIZABETHTOWN KY 42701
| Organization’s website | WWW.COMMUNITYHEALTHKY.COM |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/3/2020 |
| Organization Incorporation State | KY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F32 - Community Mental Health Center |
| 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | JOE DAN BEAVERS |
| Signature Title | DIRECTOR |
| Signature Date | 11/25/2020 |
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