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  5. MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.

MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.

Company Details

Name: MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 06 Sep 1984 (41 years ago)
Entity Number: 941712
ZIP code: 11377
County: Queens
Place of Formation: New York
Address: 40-23 62ND STREET, 2ND FLOOR, WOODSIDE, NY, United States, 11377

Contact Details

Phone +1 718-476-0076

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
6RFZ2 Active Non-Manufacturer 2012-05-29 2024-03-03 No data No data

Contact Information
POC JAMES MCQUADE
Phone +1 718-476-0076
Fax +1 718-476-0077
Address 4404 QUEENS BLVD FL 2, SUNNYSIDE, NY, 11104 2406, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAX DEFERRED ANNUITY PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2022 112700062 2023-10-05 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 111
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 624100
Sponsor’s telephone number 7184760076
Plan sponsor’s mailing address 4023 62ND ST, FLOOR 2, WOODSIDE, NY, 113775098
Plan sponsor’s address 4023 62ND ST, FLOOR 2, WOODSIDE, NY, 113775098

Number of participants as of the end of the plan year
Active participants 57
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 73
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 126
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2023-10-05
Name of individual signing DEBRA TIMMS
Valid signature Filed with authorized/valid electronic signature
401(A) THRIFT PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2021 112700062 2023-03-16 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 111
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-07-01
Business code 621420
Sponsor’s telephone number 7184760076
Plan sponsor’s mailing address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098
Plan sponsor’s address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098

Number of participants as of the end of the plan year
Active participants 60
Other retired or separated participants entitled to future benefits 59
Number of participants with account balances as of the end of the plan year 119
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 9

Signature of
Role Plan administrator
Date 2023-03-16
Name of individual signing DEBRA TIMMS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2021 112700062 2022-07-18 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 104
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 624100
Sponsor’s telephone number 7184760076
Plan sponsor’s mailing address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098
Plan sponsor’s address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098

Number of participants as of the end of the plan year
Active participants 53
Other retired or separated participants entitled to future benefits 60
Number of participants with account balances as of the end of the plan year 111
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2022-07-18
Name of individual signing DEBRA TIMMS
Valid signature Filed with authorized/valid electronic signature
401(A) THRIFT PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2020 112700062 2022-03-21 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 117
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621420
Sponsor’s telephone number 7184760076
Plan sponsor’s mailing address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098
Plan sponsor’s address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098

Number of participants as of the end of the plan year
Active participants 55
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 56
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 111
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 4

Signature of
Role Plan administrator
Date 2022-03-21
Name of individual signing DEBRA TIMMS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2020 112700062 2021-10-15 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 99
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 624100
Sponsor’s telephone number 7184760076
Plan sponsor’s mailing address 4023 62ND ST FL 2, WOODSIDE, NY, 11377
Plan sponsor’s address 4023 62ND ST FL 2, WOODSIDE, NY, 11377

Number of participants as of the end of the plan year
Active participants 54
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 50
Number of participants with account balances as of the end of the plan year 104
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing DEBRA TIMMS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2019 112700062 2021-10-15 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 89
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 624100
Sponsor’s telephone number 7184760076
Plan sponsor’s mailing address 4023 62ND ST FL 2, WOODSIDE, NY, 11377
Plan sponsor’s address 4023 62ND ST FL 2, WOODSIDE, NY, 11377

Number of participants as of the end of the plan year
Active participants 56
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 43
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 98
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing DEBRA TIMMS
Valid signature Filed with authorized/valid electronic signature
401(A) THRIFT PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2019 112700062 2021-04-15 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 108
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-07-01
Business code 621420
Plan sponsor’s address 4023 62ND ST APT 2, WOODSIDE, NY, 113775098

Signature of
Role Plan administrator
Date 2021-04-15
Name of individual signing DEBRA TIMMS
Role Employer/plan sponsor
Date 2021-04-15
Name of individual signing DEBRA TIMMS
TAX DEFERRED ANNUITY PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2018 112700062 2019-09-30 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 65
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 621420
Sponsor’s telephone number 7184760076
Plan sponsor’s address 4023 62ND ST FL 2, WOODSIDE, NY, 113774962

Signature of
Role Plan administrator
Date 2019-09-30
Name of individual signing DEBRA TIMMS
Role Employer/plan sponsor
Date 2019-09-30
Name of individual signing DEBRA TIMMS
401(A) THRIFT PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2018 112700062 2020-04-15 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 108
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-07-01
Business code 621420
Sponsor’s telephone number 7184760076
Plan sponsor’s address 4023 62ND ST FL 2, WOODSIDE, NY, 113774962

Signature of
Role Plan administrator
Date 2020-04-15
Name of individual signing DEBRA TIMMS
Role Employer/plan sponsor
Date 2020-04-15
Name of individual signing DEBRA TIMMS
401(A) THRIFT PLAN OF MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 2017 112700062 2019-04-08 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-07-01
Business code 621420
Sponsor’s telephone number 7184760076
Plan sponsor’s address 4023 62ND ST FL 2, WOODSIDE, NY, 113774962

Signature of
Role Plan administrator
Date 2019-04-08
Name of individual signing DEBRA TIMMS
Role Employer/plan sponsor
Date 2019-04-08
Name of individual signing DEBRA TIMMS

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 40-23 62ND STREET, 2ND FLOOR, WOODSIDE, NY, United States, 11377

History

Start date End date Type Value
1990-09-20 2011-04-18 Address ONE DAG HAMMARSKJOLD PLAZA, 31ST FLOOR, NEW YORK, NY, 10017, USA (Type of address: Service of Process)
1987-12-23 1990-09-20 Address ONE DAY HAMMARSKJOLD PLZ, 31ST FLOOR, NEW YORK, NY, 10017, USA (Type of address: Service of Process)
1984-09-06 1987-12-23 Address %LOUIS RAYBIN, 292 MADISON AVE., NEW YORK, NY, 10017, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
110418000812 2011-04-18 CERTIFICATE OF AMENDMENT 2011-04-18
900920000406 1990-09-20 CERTIFICATE OF AMENDMENT 1990-09-20
B582829-6 1987-12-23 CERTIFICATE OF AMENDMENT 1987-12-23
B139359-10 1984-09-06 CERTIFICATE OF INCORPORATION 1984-09-06

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
11-2700062 Corporation Unconditional Exemption 4023 62ND ST APT 2, WOODSIDE, NY, 11377-5098 1988-09
In Care of Name % SASHA COBO-BELLONE
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Educational Organization, Local Association of Employees, Agricultural Organization, Horticultural Organization, Board of Trade, Business League, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Voluntary Employees' Beneficiary Association (Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Mutual Ditch or Irrigation Co., Burial Association, Cemetery Company, Credit Union, Other Mutual Corp. or Assoc., Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2024-06
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Jun
Asset Amount 27422120
Income Amount 14050371
Form 990 Revenue Amount 13751209
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
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 MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 202306
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 202006
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 202006
Filing Type P
Return Type 990T
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 201906
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 201906
Filing Type P
Return Type 990T
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 201906
Filing Type P
Return Type 990T
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS I
EIN 11-2700062
Tax Period 201806
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 201806
Filing Type P
Return Type 990T
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS I
EIN 11-2700062
Tax Period 201706
Filing Type E
Return Type 990
File View File
Organization Name MENTAL HEALTH PROVIDERS OF WESTERN QUEENS INC
EIN 11-2700062
Tax Period 201606
Filing Type P
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1934187207 2020-04-15 0202 PPP 4023 62ND ST FL 2, WOODSIDE, NY, 11377-4962
Loan Status Date 2021-05-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1048090
Loan Approval Amount (current) 1048090
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WOODSIDE, QUEENS, NY, 11377-4962
Project Congressional District NY-06
Number of Employees 104
NAICS code 621420
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 1058218.63
Forgiveness Paid Date 2021-04-08

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Date of last update: 17 Mar 2025

Sources: New York Secretary of State

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