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MANTACHIE RURAL HEALTH CARE INC.

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Company Details

Name: MANTACHIE RURAL HEALTH CARE INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 25 Jul 1979 (46 years ago)
Business ID: 403487
State of Incorporation: MISSISSIPPI
Principal Office Address: HIGHWAY 373MANTACHIE, MS

Agent

Name Role Address
Collins, Patsy T Agent 5681 Highway 363;P O Box 40, Mantachie, MS 38855

Incorporator

Name Role Address
ALAN J RUBIN Incorporator 21 CLAYWOOD, TUPELO, MS
JULIE SHACKLEFORD Incorporator HIGHWAY 363, MANTACHIE, MS
LINDA CHIDESTER Incorporator 5500 HWY 363, P O BOX 40, MANTACHIE, MS 38855

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
JSHKFLCGLEL5
CAGE Code:
4FQG7
UEI Expiration Date:
2025-11-20

Business Information

Activation Date:
2024-11-22
Initial Registration Date:
2006-06-20

National Provider Identifier

NPI Number:
1508652330
Certification Date:
2025-04-17
Link:
View on NPI website

Authorized Person:

Name:
KAREN CRABB BURNS
Role:
COO
Phone:
6622824226

Taxonomy:

Selected Taxonomy:
261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary:
Yes

Contacts:

Phone:
+1 662-282-4226
Fax:
6622827946

Form 5500 Series

Employer Identification Number (EIN):
640646692
Plan Year:
2023
Number Of Participants:
39
Sponsors Telephone Number:
6622824226
File:
View File
Plan Year:
2022
Number Of Participants:
34
Sponsors Telephone Number:
6622824226
File:
View File
Plan Year:
2021
Number Of Participants:
36
Sponsors Telephone Number:
6622824226
File:
View File
Plan Year:
2020
Number Of Participants:
33
Sponsors Telephone Number:
6622824226
File:
View File
Plan Year:
2019
Number Of Participants:
32
Sponsors Telephone Number:
6622824226
File:
View File

Filings

Type Status Filed Date Description
Amendment Form Filed 2013-11-20 Amendment
Amendment Form Filed 2010-10-11 Amendment
Amendment Form Filed 2007-10-15 Amendment
See File Filed 1993-05-20 See File
Name Reservation Form Filed 1979-07-25 Name Reservation

USAspending Awards / Financial Assistance

Date:
2023-08-29
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2023 BRIDGE ACCESS PROGRAM
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2023-03-27
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2023 EXPANDING COVID-19 VACCINATION
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-09-20
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
HEALTH CENTER INFRASTRUCTURE SUPPORT
Obligated Amount:
543945.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-03-27
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS
Obligated Amount:
1452625.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-06-02
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
317062.00
Total Face Value Of Loan:
317062.00

Tax Exempt

Employer Identification Number (EIN) :
64-0646692
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)
Ruling Date:
1993-06
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Date Approved:
2020-06-02
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
317062
Current Approval Amount:
317062
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
321014.42

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Date of last update: 18 Apr 2025

Sources: Mississippi Secretary of State

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