Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION: MISSION: TO BE A LEADER IN ORGANIZING, PROVIDING AND SUPPORTING AFFORDABLE HEALTH CARE AND RELATED SERVICES TO THE PUBLIC THROUGH DIVERSIFIED BUSINESS ACTIVITIES. VISION: TO SET THE STANDARD IN THE PROVISION OF HEALTH CARE. CORE VALUES: COMPASSION - WE PROVIDE SERVICES IN A CARING MANNER, WITH A SYMPATHETIC CONSCIOUSNESS OF OTHERS' DISTRESS TOGETHER WITH A DESIRE TO ALLEVIATE IT. WE TREAT ALL PATIENTS AND FAMILIES WITH THE UTMOST DIGNITY AND COMPASSION. ACCOUNTABILITY - WE PERFORM IN A MANNER AT ALL TIMES THAT MAKES US ACCOUNTABLE, RESPONSIBLE, AND ANSWERABLE TO PATIENTS AND THEIR FAMILIES, OUR LEADERS, AND EMPLOYEES. RESPECT - WE TREAT PATIENTS AND EACH OTHER WITH DIGNITY, KINDNESS AND SIGNIFICANCE; VALUING DIVERSITY, ENSURING AN INTERESTING AND INCLUSIVE ENVIRONMENT AND TREATING PEOPLE AS WE WOULD LIKE TO BE TREATED OURSELVES. EXCELLENCE - WE COMMIT TO HIGH STANDARDS, NOT ACCEPT MEDIOCRITY AND STRIVE TO EXCEED OUR PATIENTS' EXPECTATIONS. SERVICES - WE PROVIDE AN ARRAY OF SERVICES DESIGNED TO IMPROVE THE QUALITY OF LIFE FOR INDIVIDUALS AND STRENGTHENING COMMUNITY TIES. IN ADDITION, WE PROVIDE EXCELLENT CUSTOMER SERVICE AS WE VALUE PATIENT SAFETY AND CONFIDENTIALITY. |
| FORM 990, PART I, LINE 6 | NUMBER OF VOLUNTEERS: TOTAL NUMBER OF VOLUNTEERS INCLUDING NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACHIEVEMENTS: THE MAIN PURPOSE OF THE ORGANIZATION IS TO PROVIDE HEALTH SERVICES TO THE MEDICALLY UNDERSERVED AND UNDER INSURED PATIENT THROUGH SERVICES SUCH AS ADULT MEDICINE, WOMEN'S HEALTH, PEDIATRICS, TEEN HEALTH, DENTISTRY, AND OPTOMETRY. DURING THE FISCAL YEAR, ALL THESE PROGRAMS ACHIEVED THIS PURPOSE. THE HOURS OPERATIONS WERE - F, 8:00 AM - 8:00 PM AND SATURDAY, 9:00 AM - 2:00 PM. SOUTHSIDE SERVED 47,024 PATIENTS, OF WHICH 14,277 INDIVIDUALS WERE SERVED THROUGH MEDICAID, 17,996 THROUGH SELF PAY, 10,961 PATIENTS THROUGH INSURANCE, AND 3,790 THROUGH MEDICARE. ADULT MEDICINE - ANY ADULT OVER 18 YEARS OF AGE MAY COME TO THE ADULT MEDICINE DEPARTMENT TO RECEIVE CARE FROM AN INTERNAL MEDICINE OF FAMILY PRACTITIONER. A FEW OF THE PRIMARY CARE SERVICES OFFERED, IN ADDITION TO GENERAL PHYSICAL EXAMS, INCLUDED FLU SHOTS; TREATMENT AND COUNSELING FOR HEART DISEASE, DIABETES AND HYPERTENSION; DRUG TESTING FOR NEW JOB HIRES; TESTING FOR THOSE SEEKING TO GET MARRIED; MEN'S HEALTH CONCERNS AND REFERRALS TO SPECIALISTS. WOMEN'S HEALTH - PATIENTS IN OUR OB/GYN DEPARTMENT FEEL WELL CARED FOR WHETHER THEY ARE RECEIVING PRENATAL OR GYNECOLOGICAL CARE. OUR PHYSICIANS DELIVER THAT CARE WITH COMPASSION, PROFESSIONALISM AND CONFIDENTIALITY. ALL PROVIDERS, AS IN THE REST OF THE ORGANIZATION, ARE BOARD CERTIFIED AND SERVE ON THE STAFF OF ALL THE MAJOR METROPOLITAN HOSPITALS. SO WOMEN HAVE A CHOICE ABOUT WHERE TO HAVE THEIR SURGERIES PERFORMED OR THEIR BABIES DELIVERED. PEDIATRICS AND TEEN HEALTH - REGULAR CHECK-UPS ARE IMPORTANT FOR THE HEALTH AND WELL BEING OF CHILDREN. OUR PEDIATRICS DEPARTMENT TREATS ILLNESS COMMON TO CHILDREN, PROVIDES HEALTH CHECK SCREENINGS AND ALL IMMUNIZATIONS FOR CHILDREN UP TO AGE 17, AND OFFERS SPORTS PHYSICALS UPON REQUEST. REFERRALS ARE MADE FROM THIS AREA TO THE DENTIST, OPTOMETRIST, ASTHMA DEPARTMENT OR OTHER SPECIALIST AS NEEDED. EACH YEAR THE PEDIATRICS DEPARTMENT SPONSORS ON ANNUAL IMMUNIZATION DRIVE WHERE, FOR ONE DAY ONLY, CHILDREN MAY RECEIVE ALL OF THEIR SHOTS AND DENTAL AND HEARING SCREENINGS FREE OF CHARGE. THIS FESTIVE OCCASION ALSO FEATURES CARTOON CHARACTERS IN COSTUME, FOOD, MUSIC, GAMES AND FREE SCHOOL SUPPLIES TO A LIMITED NUMBER OF ATTENDEES. |
| FORM 990, PART III, LINE 4C | PROGRAM SERVICE ACHIEVEMENTS: SOUTHSIDE BEHAVIORAL LIFESTYLE ENRICHMENT CENTER IS BASED ON THE BELIEF THAT RECOVERY FROM ANY TYPE OF DRUG ABUSE AND ADDICTION IS POSSIBLE THROUGH THE USE OF A WELL-INTEGRATED COMBINATION OF THERAPIES AND SERVICES. WE BELIEVE ADDICTION IS A CHRONIC, PROGRESSIVE, PRIMARY ILLNESS AFFECTING THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BEING OF THE INDIVIDUAL AND FAMILY. THEREFORE, WE TREAT DRUG ABUSE AND ADDITION IN A HOLISTIC AND INDIVIDUAL MANNER, MANAGING IT THROUGH EDUCATION, THERAPY, STRUCTURE AND SUPPORT. WE ENDEAVOR TO MATCH CLIENT NEEDS TO TREATMENT, WHEREIN THE INTENSITY OF MEDICAL, COUNSELING AND REHABILITATIVE SERVICES PROVIDED VARIES DEPENDING UPON THE CLIENT'S LENGTH OF SOBRIETY, SKILLS ACQUIRED, AND GOALS MET. WE OFFER FIVE PHASES OF TREATMENT: STABILIZATION, EARLY RECOVERY, ACTIVE RECOVERY, MAINTENANCE OR TRANSITION, AND AFTERCARE. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: OPTOMETRY - A WIDE SELECTION OF FASHIONABLE EYEWEAR TO CHOOSE FROM AND A QUICK TURN-AROUND IN THE FILLING OF EYEGLASS AND CONTACT LENS PRESCRIPTIONS MAKE THIS ONE OF OUR MOST POPULAR DEPARTMENTS. CONVENIENTLY LOCATED, THE OPTOMETRY DEPARTMENT OFFERS COMPLETE EYE EXAMS. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: THE BYLAWS OF THE ORGANIZATION WERE UPDATED TO STATE THE FOLLOWING: SECTION 4.01 COMPOSITION. THE BOARD SHALL BE COMPOSED OF NO LESS THAN NINE (9) AND NO MORE THAN THIRTEEN (13) MEMBERS. THE BOARD SHALL ESTABLISH THE EXACT NUMBER OF ITS MEMBERSHIP FROM TIME TO TIME BY RESOLUTION WHICH COMPOSITION SHALL BE AS FOLLOWS: (A) A MAJORITY OF THE BOARD MEMBERS SHALL BE INDIVIDUALS WHO ARE OR WILL BE SERVED BY THE CENTER AND WHO, AS A GROUP, REPRESENT THE INDIVIDUALS BEING SERVED OR TO BE SERVED IN ACCORDANCE WITH DEMOGRAPHIC FACTORS, SUCH AS, FOR EXAMPLE, RACE, ETHNICITY, SEX (B) NO MORE THAN ONE-HALF OF THE REMAINING MEMBERS OF THE BOARD MAY BE INDIVIDUALS WHO DERIVE MORE THAN 10 PERCENT OF THEIR ANNUAL INCOME FROM THE HEALTH CARE INDUSTRY. (C) THE REMAINING MEMBERS OF THE BOARD SHALL BE REPRESENTATIVES OF THE COMMUNITY, IN WHICH THE CENTER'S CATCHMENT AREA IS LOCATED AND SHALL BE SELECTED FOR THEIR EXPERTISE IN COMMUNITY AFFAIRS, LOCAL GOVERNMENT, FINANCE AND BANKING, LEGAL AFFAIRS, TRADE UNIONS, AND OTHER COMMERCIAL AND INDUSTRIAL CONCERNS, OR SOCIAL SERVICE AGENCIES WITHIN THE COMMUNITY. (D) NO MEMBER OF THE BOARD SHALL BE AN EMPLOYEE OF THE CENTER, OR SPOUSE, CHILD, PARENT, BROTHER OR SISTER (BLOOD OR MARRIAGE) OF SUCH AN EMPLOYEE. THE CHIEF EXECUTIVE OFFICER MAY BE A NON-VOTING, EX-OFFICIO MEMBER OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE FINANCE DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE CFO REVIEWS A TENTATIVE DRAFT OF THE FORM 990 IN DETAIL WITH THE ORGANIZATION'S INDEPENDENT ACCOUNTING FIRM. A FINAL DRAFT IS THEN PRESENTED TO THE ORGANIZATION'S FINANCE COMMITTEE. THE FULL BOARD OF DIRECTORS IS PROVIDED A COPY TO REVIEW. IN THE EVENT THAT THE NEXT BOARD MEETING IS NOT SCHEDULED UNTIL AFTER THE FILING DATE, THE FINAL RETURN IS ELECTRONICALLY MAILED TO ALL BOARD MEMBERS AND THE PRESENTATION OCCURS AT THE NEXT SCHEDULED BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: BOARD MEMBERS MUST GUARD AGAINST ANY POSSIBILITY OF CONFLICTS THAT DEVELOP BETWEEN THEIR PERSONAL INTEREST AND THOSE OF THE CORPORATION. TO ENSURE THAT CONFLICTS OF INTEREST ARE AVOIDED, A BOARD MEMBER MUST ANNUALLY DECLARE HIS OR HER PERSONAL INTEREST IN A MATTER OR TRANSACTION BEFORE IT IS CONSIDERED BY THE BOARD; DESCRIBE THE NATURE OF THE INTEREST AND ANY SIGNIFICANT REASON AS TO WHY THE TRANSACTION MAY NOT BE IN THE BOARD'S BEST INTEREST; AND REFRAIN FROM VOTING OR INFLUENCING THE BOARD'S DELIBERATIONS IN THE MATTER. ORGANIZATION OFFICERS AND KEY EMPLOYEES ALSO ANNUALLY COMPLETE A CONFLICT OF INTEREST REVIEW. ANY POTENTIAL CONFLICTS IDENTIFIED AMONG EMPLOYEES AND OFFICERS ARE REVIEWED BY THE HUMAN RESOURCE DEPARTMENT AND THE BOARD OF DIRECTORS, AS NECESSARY. RESTRICTIONS ARE IMPOSED ON INTERESTED PERSONS ON A CASE BY CASE BASIS BY THE HUMAN RESOURCES DEPARTMENT AND ARE COMMENSURATE TO THE CONFLICT IDENTIFIED. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | COMPENSATION REVIEW POLICY: TO DETERMINE, REVIEW AND APPROVE COMPENSATION OF THE CEO, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARABLE CHC DATA FROM THE AREA ON AN ANNUAL BASIS AND THIS PROCESS IS DOCUMENTED ACCORDINGLY. ADDITIONALLY THE CEO REVIEWS COMPARABLE CHC SALARY DATA FROM THE AREA TO DETERMINE, REVIEW AND APPROVE COMPENSATION OF TOP MANAGEMENT AND OFFICERS. THIS PROCESS IS DOCUMENTED AND CONDUCTED ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, CONFLICTS OF INTEREST, AND/OR FINANCIAL STATEMENTS WILL BE PROVIDED, VIA MAIL, UPON REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE, AS DETERMINED BY TOP MANAGEMENT. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:2615913 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PATIENT CARE CONSULTING TOTAL FEES:547347 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:NON-PROVIDER CONSULTING TOTAL FEES:456529 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:213815 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:211335 |
| Software ID: | |
| Software Version: |