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COMMUNITY SERVICES NORTHWEST

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Company Details

Legal Name: COMMUNITY SERVICES NORTHWEST
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Voluntarily Dissolved
Formation/ Registration Date: September 27th 2002
Date of Dissolution: December 26th 2019
Expiration date: 30 Sep 2019
UBI Number: 602 237 149
FEIN Number: 14-1848332
Purpose: Licensed outpatient cummunity mental health center; licensed intensive outpatient chemical dependency treatment center, supportive housing programs, and free mental health clinic for the uninsured.
ZIP code: 98661
City: Vancouver
County: CLARK
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1601 E FOURTH PLAIN BLVD BLDG 17, # B222, VANCOUVER, WA, 98661, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 1845, VANCOUVER, WA, 98668-1845, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $120

Contact Details

E-Mail: DPHILLIPS@CSNW.ORG
MFARMIN@CSNW.ORG
Website: www.communityservicesnw.org
Phone Number: +1 360-397-8484

Nature of Business

Charitable

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Registered Agent Information

Name Role Address
DIANA PHILLIPS Registered Agent 3412 NW 119TH ST, VANCOUVER, WA, 98685-0000, UNITED STATES

Key Officers & Management

Name Role Address
AMY WAGNER Governing Person -
SAEED HAJARIZADEH Governing Person -
SHARON CROWELL Governing Person -
SAEED HAJARIZADEH TREASURER PO Box 1845, VANCOUVER, WA, 98668, UNITED STATES
LISA MITCHELL SECRETARY PO Box 1845, VANCOUVER, WA, 98668, UNITED STATES
SHARON CROWELL PRESIDENT PO Box 1845, VANCOUVER, WA, 98668, UNITED STATES
AMY WAGNER VICE PRESIDENT PO Box 1845, VANCOUVER, WA, 98668, UNITED STATES

Unique Entity ID

CAGE Code:
5JNH3
UEI Expiration Date:
2019-11-02

Business Information

Activation Date:
2018-11-05
Initial Registration Date:
2009-06-18

Commercial and government entity program

CAGE number:
5JNH3
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2023-11-06
CAGE Expiration:
2023-11-05
CAGE Link:
View company profile on CAGE website

Contact Information

POC:
DIANA PHILLIPS

National Provider Identifier

NPI Number:
1720176894
Link:
View on NPI website

Authorized Person:

Name:
MR. JOHN P. MOREN
Role:
EXECUTIVE DIRECTOR
Phone:
3603978005

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
No
Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Phone:
+1 360-397-8484
Fax:
3603978494

Form 5500 Series

Employer Identification Number (EIN):
141848332
Plan Year:
2015
Number Of Participants:
90
Sponsor's telephone number:
3603978484
File:
View File
Plan Administrator / Signatory:
MICHELLE FARMIN(Plan administrator)
Plan Year:
2014
Number Of Participants:
95
Sponsor's telephone number:
3603978484
File:
View File
Plan Administrator / Signatory:
S.J. ROBERTSON(Plan administrator) S.J. ROBERTSON(Employer/plan sponsor)
Plan Year:
2013
Number Of Participants:
90
Sponsor's telephone number:
3603978484
File:
View File
Plan Administrator / Signatory:
S.J ROBERTSON(Plan administrator) JOHN MOREN(Employer/plan sponsor)
Plan Year:
2012
Number Of Participants:
89
Sponsor's telephone number:
3603978484
File:
View File
Plan Administrator / Signatory:
S.J.ROBERTSON(Plan administrator) S.J.ROBERTSON(Employer/plan sponsor)
Plan Year:
2011
Number Of Participants:
81
Sponsor's telephone number:
3603978484
File:
View File
Plan Administrator / Signatory:
DIANA PHILLIPS(Plan administrator)

Charity/Fundraiser/Trust

Registration Number:
1120705
Type:
CHARITABLE ORGANIZATION
Status:
Involuntarily Closed
Renewal Date:
2019-05-31

Financial History

Fiscal Begin Date:
2016-07-01
Fiscal End Date:
2017-06-30
Begin Assets:
$3,927,283.00
Revenue:
$8,861,715.00
Program Services:
$7,728,506.00
Expenses:
$9,019,463.00
End Assets:
$3,862,080.00
% To Program Services:
86%
Fiscal Begin Date:
2015-07-01
Fiscal End Date:
2016-06-30
Begin Assets:
$3,186,631.00
Revenue:
$8,654,873.00
Program Services:
$6,991,450.00
Expenses:
$8,336,869.00
End Assets:
$3,927,283.00
% To Program Services:
84%
Fiscal Begin Date:
2014-07-01
Fiscal End Date:
2015-06-30
Begin Assets:
$2,153,629.00
Revenue:
$7,549,844.00
Program Services:
$5,988,616.00
Expenses:
$7,037,032.00
End Assets:
$3,186,631.00
% To Program Services:
85%
Fiscal Begin Date:
2013-07-01
Fiscal End Date:
2014-06-30
Begin Assets:
$1,502,804.00
Revenue:
$5,644,389.00
Program Services:
$4,553,539.00
Expenses:
$5,420,978.00
End Assets:
$1,726,215.00
% To Program Services:
84%
Fiscal Begin Date:
2012-07-01
Fiscal End Date:
2013-06-30
Begin Assets:
$2,252,142.00
Revenue:
$4,782,566.00
Program Services:
$4,135,546.00
Expenses:
$4,996,017.00
End Assets:
$2,094,999.00
% To Program Services:
83%
Registration Number:
1328972
Type:
CHARITABLE TRUST
Status:
Involuntarily Closed
Renewal Date:
2019-05-31

Financial History

Fiscal Begin Date:
2016-07-01
Fiscal End Date:
2017-06-30
Begin Assets:
$3,927,283.00
Revenue:
$8,820,786.00
Expenses:
$9,019,463.00
End Assets:
$3,862,080.00
Grant Contributions Program Service:
$8,707,917.00
Fiscal Begin Date:
2015-07-01
Fiscal End Date:
2016-06-30
Begin Assets:
$3,186,631.00
Revenue:
$8,434,350.00
Expenses:
$8,116,256.00
End Assets:
$3,927,283.00
Compensation:
$109,599.00
Grant Contributions Program Service:
$67,715,107.00
Fiscal Begin Date:
2014-07-01
Fiscal End Date:
2015-06-30
Begin Assets:
$2,153,629.00
Revenue:
$7,328,730.00
Expenses:
$6,823,894.00
End Assets:
$3,186,631.00
Compensation:
$94,902.00
Grant Contributions Program Service:
$5,775,478.00
Fiscal Begin Date:
2013-07-01
Fiscal End Date:
2014-06-30
Begin Assets:
$2,094,999.00
Revenue:
$5,644,389.00
Expenses:
$5,420,978.00
End Assets:
$2,153,629.00
Compensation:
$86,557.00
Grant Contributions Program Service:
$4,553,539.00
Fiscal Begin Date:
2012-07-01
Fiscal End Date:
2013-06-30
Begin Assets:
$2,252,142.00
Revenue:
$4,782,566.00
Expenses:
$4,996,017.00
End Assets:
$2,094,999.00
Compensation:
$91,756.00
Grant Contributions Program Service:
$4,135,546.00
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