| Field | Data |
|---|---|
| EIN | 84-3214402 |
| Case Number | EO-2019277-000433 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | LIFE AND FAMILY MEDICAL CLINIC |
| Organization’s Mailing Address | 2740 HAPPY JOE DRIVE STE 1 |
| City | BETTENDORF |
| State | IA |
| ZIP | 52722 |
| Accounting period End | 12 |
| Primary contact name | TIMOTHY GULBRANSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
MARY JONES
PRESIDENT
1713 WESTMINSTER CIRCLE
DAVENPORT IA 52807
MARY WALSH
VICE PRESIDENT
4247 EAST 58TH STREET
DAVENPORT IA 52807
KAREN GARNER
SECRETARY
2021 8TH STREET
EAST MOLINE IL 61244
BETH MILLEA
TREASURER
2939 EAST 44TH COURT
DAVENPORT IA 52807
CHRISTY LAYER
BOARD MEMBER
1068 20TH AVENUE
EAST MOLINE IL 61244
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/23/19 |
| Organization Incorporation State | IA |
| 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 | MARY JONES |
| Signature Title | PRESIDENT |
| Signature Date | 9/30/19 |
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