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  5. EVERGREEN SUPPORTED LIVING

EVERGREEN SUPPORTED LIVING

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Company Details

Legal Name: EVERGREEN SUPPORTED LIVING
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 11th 1982
Expiration date: 28 Feb 2026
UBI Number: 601 060 112
FEIN Number: 91-1177243
Purpose: TO PROVIDE SUPPORTED LIVING AND COMMUNITY INTEGRATION SERVICES TO ADULTS WITH DEVELOPMENTAL DISABILITIES.
ZIP code: 98225
City: Bellingham
County: WHATCOM
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 305 FLORA ST, BELLINGHAM, WA, 98225-4430, UNITED STATES

Contact Details

E-Mail: ZAY@EVERGREENHOME.ORG
Phone Number: +1 360-671-5898

Nature of Business

Charitable, Social, Any Lawful Purpose, SUPPORTIVE SERVICES FOR ADULTS WITH DEVELOPMENTAL DISABILITIES.

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Registered Agent Information

Name Role Address
ZAY MCSHANE Registered Agent 305 FLORA ST, BELLINGHAM, WA, 98225-4430, UNITED STATES

Key Officers & Management

Name Role Address
KATHIE UUSITALO Governing Person -
BRYAN BRINK Governing Person -
ZAY MCSHANE Governing Person 1970 FRASER ST APT 106, BELLINGHAM, WA, 98229-3794, UNITED STATES
MARY ELLEN HUUS Governing Person -
NEIL MCKAY Governing Person -
ZAY MCSHANE EXECUTIVE DIRECTOR 305 FLORA ST, BELLINGHAM, WA, 98225-4430, UNITED STATES

Unique Entity ID

Unique Entity ID:
UYRDMM441DW6
CAGE Code:
9KBH6
UEI Expiration Date:
2025-09-30

Business Information

URL:
www.evergreenhome.org
Activation Date:
2024-10-02
Initial Registration Date:
2023-05-02

National Provider Identifier

NPI Number:
1124767587
Certification Date:
2022-06-02
Link:
View on NPI website

Authorized Person:

Name:
ZAY AIDAN SMITH MCSHANE
Role:
EXECUTIVE DIRECTOR
Phone:
3606715898

Taxonomy:

Selected Taxonomy:
106S00000X - Behavior Technician
Is Primary:
No
Selected Taxonomy:
251B00000X - Case Management Agency
Is Primary:
No
Selected Taxonomy:
251C00000X - Developmentally Disabled Services Day Training Agency
Is Primary:
No
Selected Taxonomy:
253Z00000X - In Home Supportive Care Agency
Is Primary:
No
Selected Taxonomy:
374U00000X - Home Health Aide
Is Primary:
No
Selected Taxonomy:
320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Is Primary:
Yes

Contacts:

Phone:
+1 360-671-5898
Fax:
3609220648

Form 5500 Series

Employer Identification Number (EIN):
911177243
Plan Year:
2024
Number Of Participants:
0
Plan Name:
401(K)
Sponsor's telephone number:
3606715898
File:
View File
Plan Administrator / Signatory:
QIAN LIU(Plan administrator)

Tax Exempt

Employer Identification Number (EIN):
91-1177243
In Care Of Name:
% EXEC DIRECTOR
Ruling Date:
2020-11
National Taxonomy Of Exempt Entities:
Human Services: Developmentally Disabled Centers
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

Link:
Download file

Copies of Returns

Return Type:
990
Tax Period:
202312
Link:
Download 990
Return Type:
990
Tax Period:
202212
Link:
Download 990
Return Type:
990
Tax Period:
202112
Link:
Download 990

Charity/Fundraiser/Trust

Registration Number:
1129635
Type:
CHARITABLE ORGANIZATION
Status:
Active
Renewal Date:
2025-11-30

Financial History

Fiscal Begin Date:
2023-01-01
Fiscal End Date:
2023-12-31
Begin Assets:
$884,122.00
Revenue:
$4,004,595.00
Program Services:
$3,042,821.00
Expenses:
$3,416,306.00
End Assets:
$1,472,411.00
% To Program Services:
89%
Fiscal Begin Date:
2022-01-01
Fiscal End Date:
2022-12-31
Begin Assets:
$738,287.00
Revenue:
$3,448,827.00
Program Services:
$2,961,125.00
Expenses:
$3,302,992.00
End Assets:
$884,122.00
% To Program Services:
90%
Fiscal Begin Date:
2021-01-01
Fiscal End Date:
2021-12-31
Begin Assets:
$710,916.00
Revenue:
$3,231,617.00
Program Services:
$2,689,628.00
Expenses:
$2,946,146.00
End Assets:
$738,287.00
% To Program Services:
91%
Fiscal Begin Date:
2020-01-01
Fiscal End Date:
2020-12-31
Begin Assets:
$423,419.00
Revenue:
$3,032,275.00
Program Services:
$2,469,562.00
Expenses:
$2,743,747.00
End Assets:
$710,916.00
% To Program Services:
90%
Fiscal Begin Date:
2019-01-01
Fiscal End Date:
2019-12-31
Begin Assets:
$402,861.00
Revenue:
$2,058,225.00
Program Services:
$1,844,047.00
Expenses:
$2,055,224.00
End Assets:
$423,419.00
% To Program Services:
90%
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