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CASCADE COMMUNITY HEALTHCARE

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Company Details

Legal Name: CASCADE COMMUNITY HEALTHCARE
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: August 1st 1966
Expiration date: 31 Aug 2025
UBI Number: 600 235 909
FEIN Number: 91-0836093
ZIP code: 98531
City: Centralia
County: LEWIS
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 2428 W REYNOLDS AVE, CENTRALIA, WA, 98531-4554, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $244,681

Contact Details

E-Mail: STRIDER@CASCADEMENTALHEALTH.ORG
Phone Number: +1 360-330-9044

Nature of Business

Social

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Registered Agent Information

Name Role Address
CHIEF EXECUTIVE OFFICER Registered Agent 2428 W REYNOLDS AVE, CENTRALIA, WA, 98531-4554, UNITED STATES

Key Officers & Management

Name Role
RON AVERILL Governing Person
MICHAEL ERVIN Governing Person
DR DUSTIN LEWIS Governing Person
DUSTIJN LEWIS Governing Person

Unique Entity ID

Unique Entity ID:
KWD9H24R7ZP5
CAGE Code:
8G2C4
UEI Expiration Date:
2025-10-17

Business Information

Activation Date:
2024-10-23
Initial Registration Date:
2019-12-16

National Provider Identifier

NPI Number:
1568152486
Certification Date:
2025-04-28

Authorized Person:

Name:
PAMELA TRUMBLE
Role:
CREDENTIALING
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
910836093
Plan Year:
2017
Number Of Participants:
145
Sponsor's telephone number:
Plan Year:
2017
Number Of Participants:
108
Sponsor's telephone number:
Plan Year:
2017
Number Of Participants:
163
Sponsor's telephone number:
Plan Year:
2009
Number Of Participants:
118
Sponsor's DBA Name:
CASCADE MENTAL HEALTH CARE
Sponsor's telephone number:
Plan Administrator / Signatory:
H. SUE KILLILLAY(Plan administrator)

History

Type Old value New value Date of change
Name change LEWIS COUNTY MENTAL HEALTH ASSOCIATION CASCADE COMMUNITY HEALTHCARE 2019-10-17

Tax Exempt

Employer Identification Number (EIN):
91-0836093
In Care Of Name:
% RICHARD STRIDE
Ruling Date:
1968-09
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns

Return Type:
990
Tax Period:
202206
Link:
Return Type:
990
Tax Period:
202006
Link:
Return Type:
990
Tax Period:
201906
Link:

Paycheck Protection Program

Jobs Reported:
137
Initial Approval Amount:
$1,500,000
Date Approved:
2020-04-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,500,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$1,508,532.61
Servicing Lender:
Security State Bank
Use of Proceeds:
Payroll: $1,500,000
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