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GOOD SAMARITAN COMMUNITY HEALTH, INC. - Florida Company Profile

Company Details

Entity Name: GOOD SAMARITAN COMMUNITY HEALTH, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 27 May 2004 (21 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 27 Jul 2007 (18 years ago)
Document Number: N04000005372
FEI/EIN Number 201192339

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 7701 SW 98TH ST., MIAMI, FL, 33156
Mail Address: 7110 SW 109TH TERR., MIAMI, FL, 33156
ZIP code: 33156
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1104006824 2007-11-09 2022-07-21 7110 SW 109TH TER, MIAMI, FL, 331563968, US 7701 SW 98TH ST, MIAMI, FL, 331562634, US

Contacts

Phone +1 305-661-0171
Fax 3054686349
Phone +1 305-316-7444

Authorized person

Name DR. JOSE ROBERTO NERY
Role PRESIDENT
Phone 3053167444

Taxonomy

Taxonomy Code 261QC1500X - Community Health Clinic/Center
State FL
Is Primary Yes

Key Officers & Management

Name Role Address
MOSTAFA JONAS Vice President 8585 SW 80TH PLACE, MIAMI, FL, 33143
NERY DEBORA Treasurer 7110 SW 109TH TERRACE, MIAMI, FL, 33156
SIMOES CARLOS A COUN 4181 SW 188 AV, MIRAMAR, FL, 33029
Young Steven R Coun 10729 SW 104 Street, Miami, FL, 33176
NERY JOSE R Agent 7110 SW 109TH TERRACE, MIAMI, FL, 33156
LOZADA DIEGO SEQUERA Exec 6841 SW 78 TH TER, SOUTH MIAMI, FL, 33143
NERY JOSE R President 7110 SW 109TH TERRACE, MIAMI, FL, 33156

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2007-08-10 7701 SW 98TH ST., MIAMI, FL 33156 -
CHANGE OF MAILING ADDRESS 2007-08-10 7701 SW 98TH ST., MIAMI, FL 33156 -
NAME CHANGE AMENDMENT 2007-07-27 GOOD SAMARITAN COMMUNITY HEALTH, INC. -

Documents

Name Date
ANNUAL REPORT 2024-02-29
ANNUAL REPORT 2023-01-29
ANNUAL REPORT 2022-01-27
ANNUAL REPORT 2021-01-26
ANNUAL REPORT 2020-03-25
ANNUAL REPORT 2019-03-14
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-02-18
ANNUAL REPORT 2015-03-19

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
20-1192339 Corporation Unconditional Exemption 7701 SW 98TH ST, MIAMI, FL, 33156-2634 2014-12
In Care of Name % JOSE R NERY
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, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, 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 2022-12
Asset 25,000 to 99,999
Income 100,000 to 499,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 80431
Income Amount 133797
Form 990 Revenue Amount 133797
National Taxonomy of Exempt Entities Health Care: Hospitals and Related Primary Medical Care Facilities
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)

Auto-Revocation List

Description Organizations whose federal tax exempt status was automatically revoked for not filing a Form 990-series return or notice for three consecutive years. Important note: Just because an organization appears on this list, it does not mean the organization is currently revoked, as they may have been reinstated.
Exemption Type 501(c)(3): Religious, educational, charitable, scientific, literary, testing for public safety, fostering national or international amateur sports competition, or prevention of cruelty to children or animals organizations
Revocation Date 2010-05-15
Revocation Posting Date 2011-06-09
Exemption Reinstatement Date 2010-05-15

Determination Letter

Final Letter(s) FinalLetter_20-1192339_GOODSAMARITANCOMMUNITYHEALTHINC_11242014.tif

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 201612
Filing Type E
Return Type 990EZ
File View File
Organization Name GOOD SAMARITAN COMMUNITY HEALTH INC
EIN 20-1192339
Tax Period 201512
Filing Type E
Return Type 990EZ
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5128837706 2020-05-01 0455 PPP 7701 SW 98TH ST, MIAMI, FL, 33156-2634
Loan Status Date 2021-07-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 20000
Loan Approval Amount (current) 20000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address MIAMI, MIAMI-DADE, FL, 33156-2634
Project Congressional District FL-27
Number of Employees 4
NAICS code 621999
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 20129.2
Forgiveness Paid Date 2021-02-12

Date of last update: 01 Apr 2025

Sources: Florida Department of State