Name: | ADIRONDACK MEDICAL CENTER |
Jurisdiction: | New York |
Legal type: | DOMESTIC NOT-FOR-PROFIT CORPORATION |
Status: | Active |
Date of registration: | 28 Dec 1990 (34 years ago) |
Entity Number: | 1498264 |
ZIP code: | 12983 |
County: | Franklin |
Place of Formation: | New York |
Address: | PO BOX 471, SARANAC LAKE, NY, United States, 12983 |
Contact Details
Phone +1 518-897-2366
Phone +1 518-523-1327
Phone +1 518-359-7000
Phone +1 518-359-3355
Phone +1 518-891-4141
Phone +1 518-897-2850
Phone +1 518-897-2636
Phone +1 518-523-3311
Phone +1 518-576-9771
Phone +1 518-897-2378
Phone +1 518-897-2871
Phone +1 518-897-2641
Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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L8H7N9EMB5S7 | 2024-11-13 | 2233 STATE ROUTE 86, SARANAC LAKE, NY, 12983, 5644, USA | P.O. BOX 471, 2233 STATE RT 86, SARANAC LAKE, NY, 12983, 5644, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Doing Business As | ADIRONDACK HEALTH |
URL | http://www.adirondackhealth.org |
Congressional District | 21 |
State/Country of Incorporation | NY, USA |
Activation Date | 2023-11-15 |
Initial Registration Date | 2004-02-09 |
Entity Start Date | 1992-01-01 |
Fiscal Year End Close Date | Dec 31 |
Service Classifications
NAICS Codes | 621112, 621399, 621999, 622110 |
Product and Service Codes | Q201 |
Points of Contacts
Electronic Business | |
---|---|
Title | PRIMARY POC |
Name | EMILY MOULTON |
Role | GRANT COORDINATOR |
Address | P.O. BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 12983, 5644, USA |
Government Business | |
---|---|
Title | PRIMARY POC |
Name | EMILY MOULTON |
Role | GRANT COORDINATOR |
Address | P.O. BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 12983, 5644, USA |
Title | ALTERNATE POC |
Name | PATTI THOMPSON |
Address | P.O. BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 12983, 0471, USA |
Past Performance | Information not Available |
---|
CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
3Q1N7 | Active | Non-Manufacturer | 2004-02-09 | 2024-03-10 | 2028-11-15 | 2024-11-13 | |||||||||||||
|
POC | EMILY MOULTON |
Phone | +1 518-897-2597 |
Address | 2233 STATE ROUTE 86, SARANAC LAKE, NY, 12983 5644, UNITED STATES |
Ownership of Offeror Information
Highest Level Owner | Information not Available |
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Immediate Level Owner | Information not Available |
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List of Offerors (0) | Information not Available |
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Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN | 2023 | 141731786 | 2024-07-12 | ADIRONDACK MEDICAL CENTER | 633 | |||||||||||||||||||||||||||||||||||||||
|
Active participants | 621 |
Retired or separated participants receiving benefits | 3 |
Signature of
Role | Plan administrator |
Date | 2024-07-12 |
Name of individual signing | CONNER LABAR |
Valid signature | Filed with authorized/valid electronic signature |
Role | Employer/plan sponsor |
Date | 2024-07-12 |
Name of individual signing | CONNER LABAR |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s mailing address | 2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471 |
Plan sponsor’s address | 2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471 |
Number of participants as of the end of the plan year
Active participants | 630 |
Retired or separated participants receiving benefits | 3 |
Signature of
Role | Plan administrator |
Date | 2023-07-31 |
Name of individual signing | MELANIE SLEIME |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s mailing address | 2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471 |
Plan sponsor’s address | 2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471 |
Number of participants as of the end of the plan year
Active participants | 659 |
Retired or separated participants receiving benefits | 4 |
Signature of
Role | Plan administrator |
Date | 2022-07-29 |
Name of individual signing | MELANIE SLEIME |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s mailing address | 2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471 |
Plan sponsor’s address | 2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471 |
Number of participants as of the end of the plan year
Active participants | 693 |
Retired or separated participants receiving benefits | 3 |
Signature of
Role | Plan administrator |
Date | 2021-07-21 |
Name of individual signing | DEREK TRACY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s DBA name | ADIRONDACK HEALTH |
Plan sponsor’s mailing address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Plan sponsor’s address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Number of participants as of the end of the plan year
Active participants | 668 |
Retired or separated participants receiving benefits | 3 |
Other retired or separated participants entitled to future benefits | 0 |
Signature of
Role | Plan administrator |
Date | 2020-08-18 |
Name of individual signing | DEREK TRACY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s DBA name | ADIRONDACK HEALTH |
Plan sponsor’s mailing address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Plan sponsor’s address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Number of participants as of the end of the plan year
Active participants | 630 |
Retired or separated participants receiving benefits | 3 |
Signature of
Role | Plan administrator |
Date | 2019-08-01 |
Name of individual signing | DEREK TRACY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s DBA name | ADIRONDACK HEALTH |
Plan sponsor’s mailing address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Plan sponsor’s address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Number of participants as of the end of the plan year
Active participants | 653 |
Retired or separated participants receiving benefits | 3 |
Signature of
Role | Plan administrator |
Date | 2018-08-13 |
Name of individual signing | DANA KELLERMAN |
Valid signature | Filed with authorized/valid electronic signature |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s DBA name | ADIRONDACK HEALTH |
Plan sponsor’s mailing address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Plan sponsor’s address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Number of participants as of the end of the plan year
Active participants | 653 |
Retired or separated participants receiving benefits | 3 |
Signature of
Role | Employer/plan sponsor |
Date | 2018-08-13 |
Name of individual signing | DANA KELLERMAN |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s DBA name | ADIRONDACK HEALTH |
Plan sponsor’s mailing address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Plan sponsor’s address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Number of participants as of the end of the plan year
Active participants | 618 |
Retired or separated participants receiving benefits | 4 |
Signature of
Role | Plan administrator |
Date | 2017-07-28 |
Name of individual signing | DANA KELLERMAN |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 502 |
Effective date of plan | 2008-01-01 |
Business code | 622000 |
Sponsor’s telephone number | 5188972413 |
Plan sponsor’s DBA name | ADIRONDACK HEALTH |
Plan sponsor’s mailing address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Plan sponsor’s address | PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644 |
Number of participants as of the end of the plan year
Active participants | 596 |
Retired or separated participants receiving benefits | 4 |
Other retired or separated participants entitled to future benefits | 0 |
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
Signature of
Role | Plan administrator |
Date | 2016-07-25 |
Name of individual signing | MIKE LEE |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role | Address |
---|---|---|
THE CORPORATION | DOS Process Agent | PO BOX 471, SARANAC LAKE, NY, United States, 12983 |
Start date | End date | Type | Value |
---|---|---|---|
1990-12-28 | 2006-12-21 | Address | LAKE COLBY DRIVE, SARANAC LAKE, NY, 12983, USA (Type of address: Service of Process) |
Filing Number | Date Filed | Type | Effective Date |
---|---|---|---|
061221000893 | 2006-12-21 | CERTIFICATE OF AMENDMENT | 2006-12-21 |
901228000395 | 1990-12-28 | CERTIFICATE OF CONSOLIDATION | 1990-12-28 |
Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
DO | AWARD | DJBRBK083018 | 2008-06-30 | 2008-09-30 | 2009-09-30 | |||||||||||||||||||||
|
Title | 151060- FCI RAY BROOK INPATIENT AND OUTPATIENT FACILITY SERVICES, 3RD QUARTER 2008 |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_AWD_DJBRBK082018_1540_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | 151060-FCI RAY BROOK INPATIENT AND OUTPATIENT FACILITY SERVICES, 1ST QUARTER 2008 |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_AWD_DJBRBKHB230215_1540_-NONE-_-NONE- |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, 2233 STATE RT 86, SARANAC LAKE, 129835644 |
Unique Award Key | CONT_AWD_DJBRBKHB130046_1540_-NONE-_-NONE- |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | TEMPORARY PHARMACIST SERVICES FOR FCI RAY BROOK FROM 02/12/2008 THROUGH 02/19/2008. |
NAICS Code | 446110: PHARMACIES AND DRUG STORES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, 2233 STATE RT 86, SARANAC LAKE, 129835644 |
Unique Award Key | CONT_AWD_DJBRBK081018_1540_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | FCI RAY BROOK INPATIENT AND OUTPATIENT SERVICES, 1ST QUARTER 2008 |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_AWD_DJBRBK074018_1540_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | 4TH QUARTER MEDICAL EXPENSES AT CONTRACT HOSPITAL FOR VARIOUS INMATES. |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_AWD_DJBRBKHB230017_1540_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | CONTRACT HOSPITAL, GUARANTEED MINIMUM FOR FISCAL YEAR 2008. |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_IDV_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | FCI RAY BROOK INPATIENT AND OUTPATIENT FACILITY SERVICES |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_AWD_DJBRBK093018_1540_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | 151060----FCI RAY BROOK INPATIENT AND OUTPATIENT FACILITY SERVICES, 3RD QUARTER 2009 |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
Unique Award Key | CONT_AWD_DJBRBK092018_1540_DJB21203018_1540 |
Awarding Agency | Department of Justice |
Link | View Page |
Description
Title | FCI RAY BROOK INPATIENT AND OUTPATIENT FACILITY SERVICES, 2ND QUARTER, FISCAL YEAR 2009. |
NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | ADIRONDACK MEDICAL CENTER |
UEI | L8H7N9EMB5S7 |
Legacy DUNS | 060544657 |
Recipient Address | UNITED STATES, LAKE COLBY DRIVE, SARANAC LAKE, 129830471 |
FAIN | Awarding Agency | Assistance Listings | Start Date | End Date | Description | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
C76HF09998 | Department of Health and Human Services | 93.887 - HEALTH CARE AND OTHER FACILITIES | 2008-09-01 | 2010-08-31 | HEALTH CARE AND OTHER FACILITIES | |||||||||||||||||||||
|
Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
310750120 | 0215800 | 2007-07-25 | 114 PARK STREET, TUPPER LAKE, NY, 12986 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
310750203 | 0215800 | 2007-07-25 | 114 PARK STREET, TUPPER LAKE, NY, 12986 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Type | Inspection |
Activity Nr | 310750120 |
Violation Items
Citation ID | 01001 |
Citaton Type | Serious |
Standard Cited | 19100146 C02 |
Issuance Date | 2007-10-23 |
Abatement Due Date | 2007-10-26 |
Current Penalty | 525.0 |
Initial Penalty | 525.0 |
Nr Instances | 1 |
Nr Exposed | 1 |
Gravity | 01 |
Citation ID | 02001 |
Citaton Type | Other |
Standard Cited | 19100253 B02 IV |
Issuance Date | 2007-10-23 |
Abatement Due Date | 2007-10-26 |
Nr Instances | 1 |
Nr Exposed | 1 |
Gravity | 01 |
Inspection Type | Complaint |
Scope | Partial |
Safety/Health | Safety |
Close Conference | 2004-03-10 |
Case Closed | 2004-04-05 |
Related Activity
Type | Complaint |
Activity Nr | 204274757 |
Safety | Yes |
Violation Items
Citation ID | 01001 |
Citaton Type | Other |
Standard Cited | 19100037 A03 |
Issuance Date | 2004-03-17 |
Abatement Due Date | 2004-04-04 |
Nr Instances | 1 |
Nr Exposed | 2 |
Gravity | 01 |
EIN | Type of Organization | Exempt Organization Status | Address | Ruling Date | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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14-1731786 | Corporation | Unconditional Exemption | 2233 STATE ROUTE 86, SARANAC LAKE, NY, 12983-5644 | 1992-01 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Description | Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. |
On Publication 78 Data List | Yes |
Deductibility | Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions) |
Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 202212 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 202112 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 202012 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 201912 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 201812 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 201712 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 201612 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | ADIRONDACK MEDICAL CENTER |
EIN | 14-1731786 |
Tax Period | 201512 |
Filing Type | E |
Return Type | 990 |
File | View File |
Date of last update: 26 Feb 2025
Sources: New York Secretary of State