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DELTA HEALTH CENTER, INC.

Company Details

Name: DELTA HEALTH CENTER, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 27 Feb 1967 (58 years ago)
Business ID: 525863
State of Incorporation: MISSISSIPPI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2023 640443928 2024-10-10 DELTA HEALTH CENTER, INC. 162
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 168
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 13
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 108
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 7

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2022 640443928 2024-08-14 DELTA HEALTH CENTER, INC. 125
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 149
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 15
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 104
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 8

Signature of
Role Plan administrator
Date 2024-08-14
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2022 640443928 2023-10-12 DELTA HEALTH CENTER, INC. 125
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 145
Other retired or separated participants entitled to future benefits 17
Number of participants with account balances as of the end of the plan year 118
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 8

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2022 640443928 2023-10-12 DELTA HEALTH CENTER, INC. 125
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 145
Other retired or separated participants entitled to future benefits 17
Number of participants with account balances as of the end of the plan year 118
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 8

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2021 640443928 2023-10-06 DELTA HEALTH CENTER, INC. 143
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 87
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 13
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 93
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 4

Signature of
Role Plan administrator
Date 2023-10-06
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2021 640443928 2022-10-17 DELTA HEALTH CENTER, INC. 143
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 109
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 16
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 99
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 4

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2020 640443928 2021-10-11 DELTA HEALTH CENTER, INC. 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 127
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 16
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 97
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 13

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 640443928 2020-05-21 DELTA HEALTH CENTER, INC. 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 80
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 9
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 88
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 6

Signature of
Role Plan administrator
Date 2020-05-21
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2018 640443928 2019-09-20 DELTA HEALTH CENTER, INC. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 67
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 7
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 71
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 6

Signature of
Role Plan administrator
Date 2019-09-20
Name of individual signing JOHN A FAIRMAN
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2017 640443928 2018-08-14 DELTA HEALTH CENTER, INC. 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 78
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 74
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 3

Signature of
Role Plan administrator
Date 2018-08-14
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-14
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/03/22/20180322091722P040006395053001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 85
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 80
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 7

Signature of
Role Plan administrator
Date 2018-03-22
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 85
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 80
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 7

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s mailing address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Number of participants as of the end of the plan year
Active participants 85
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 80
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 7

Signature of
Role Plan administrator
Date 2018-03-06
Name of individual signing MYRTIS SMALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/11/14/20161114124711P040010846743001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418800
Plan sponsor’s address 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 387629314

Signature of
Role Plan administrator
Date 2016-11-11
Name of individual signing JOHN FAIRMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-11-11
Name of individual signing JOHN FAIRMAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/01/20150701144944P030086707377001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418880
Plan sponsor’s address 702 MARTIN LUTHER KING ST., MOUND BAYOU, MS, 38762

Signature of
Role Plan administrator
Date 2015-07-01
Name of individual signing JOHN FAIRMAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/14/20141014102821P030019557517001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627418880
Plan sponsor’s address 702 MARTIN LUTHER KING ST., MOUND BAYOU, MS, 38762

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing DELTA HEALTH CENTER INC.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/08/05/20130805110405P040337488227001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6627412151
Plan sponsor’s address 702 MARTIN LUTHER KING ST., MOUND BAYOU, MS, 38762

Signature of
Role Plan administrator
Date 2013-08-05
Name of individual signing DELTA HEALTH CENTER INC.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/02/13/20130213174649P040091607667001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Signature of
Role Plan administrator
Date 2013-02-13
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-02-13
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/13/20120913163409P040004059412001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2011-09-20
Business code 622000
Sponsor’s telephone number 6627412151
Plan sponsor’s address 702 MARTIN LUTHER KING ST., MOUND BAYOU, MS, 38762

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER INC.
Plan administrator’s address 702 MARTIN LUTHER KING ST., MOUND BAYOU, MS, 38762
Administrator’s telephone number 6627412151

Signature of
Role Plan administrator
Date 2012-09-13
Name of individual signing DELTA HEALTH CENTER INC.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/12/20121012084734P040001374278001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER, INC.
Plan administrator’s address PO BOX 900, MOUND BAYOU, MS, 387620900
Administrator’s telephone number 6017412151

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-12
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/11/15/20111115133215P040005715153001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER, INC.
Plan administrator’s address PO BOX 900, MOUND BAYOU, MS, 387620900
Administrator’s telephone number 6017412151

Signature of
Role Plan administrator
Date 2011-11-15
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-11-15
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER, INC.
Plan administrator’s address PO BOX 900, MOUND BAYOU, MS, 387620900
Administrator’s telephone number 6017412151

Signature of
Role Plan administrator
Date 2011-05-26
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-26
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER, INC.
Plan administrator’s address PO BOX 900, MOUND BAYOU, MS, 387620900
Administrator’s telephone number 6017412151

Signature of
Role Plan administrator
Date 2010-11-30
Name of individual signing JAMES ELLA JONES
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-11-30
Name of individual signing JAMES ELLA JONES
Valid signature Filed with incorrect/unrecognized electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/18/20110218082416P040001858290001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER, INC.
Plan administrator’s address PO BOX 900, MOUND BAYOU, MS, 387620900
Administrator’s telephone number 6017412151

Signature of
Role Plan administrator
Date 2011-02-18
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-02-18
Name of individual signing JAMES JONES
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1989-08-01
Business code 621111
Sponsor’s telephone number 6017412151
Plan sponsor’s address PO BOX 900, MOUND BAYOU, MS, 387620900

Plan administrator’s name and address
Administrator’s EIN 640443928
Plan administrator’s name DELTA HEALTH CENTER, INC.
Plan administrator’s address PO BOX 900, MOUND BAYOU, MS, 387620900
Administrator’s telephone number 6017412151

Signature of
Role Plan administrator
Date 2011-02-11
Name of individual signing JAMES JONES
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-02-11
Name of individual signing JAMES JONES
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
Fairman, John A Agent 702 Martin Luther King Road;P O Box 900, Mound Bayou, MS 38762

Filings

Type Status Filed Date Description
Amendment Form Filed 2010-04-08 Amendment
Amendment Form Filed 1992-05-18 Amendment
Amendment Form Filed 1985-11-06 Amendment
Name Reservation Form Filed 1967-02-27 Name Reservation

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
C76HF16182 Department of Health and Human Services 93.887 - HEALTH CARE AND OTHER FACILITIES 2009-09-01 2010-08-31 HEALTH CARE AND OTHER FACILITIES
Recipient DELTA HEALTH CENTER, INC.
Recipient Name Raw DELTA HEALTH CENTER, INC
Recipient UEI GHKAM4REGNL9
Recipient DUNS 067718825
Recipient Address P.O. BOX 900, MOUND BAYOU, BOLIVAR, MISSISSIPPI, 38762-0900, UNITED STATES
Obligated Amount 141570.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
C81CS13796 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-06-29 2011-06-28 ARRA - CAPITAL IMPROVEMENT PROGRAM
Recipient DELTA HEALTH CENTER, INC.
Recipient Name Raw DELTA HEALTH CENTER, INC
Recipient UEI GHKAM4REGNL9
Recipient DUNS 067718825
Recipient Address P.O. BOX 900, MOUND BAYOU, BOLIVAR, MISSISSIPPI, 38762-0900, UNITED STATES
Obligated Amount 537455.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H8BCS12185 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-03-27 2011-03-26 ARRA - INCREASE SERVICES TO HEALTH CENTERS
Recipient DELTA HEALTH CENTER, INC.
Recipient Name Raw DELTA HEALTH CENTER, INC
Recipient UEI GHKAM4REGNL9
Recipient DUNS 067718825
Recipient Address P.O. BOX 900, MOUND BAYOU, BOLIVAR, MISSISSIPPI, 38762-0900, UNITED STATES
Obligated Amount 239597.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H76HA00744 Department of Health and Human Services 93.918 - GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE 2002-09-30 2008-03-31 RYAN WHITE PART C OUTPATIENT EIS PROGRAM
Recipient DELTA HEALTH CENTER, INC.
Recipient Name Raw DELTA HEALTH CENTER, INC
Recipient UEI GHKAM4REGNL9
Recipient DUNS 067718825
Recipient Address PO BOX 900, MOUND BAYOU, BOLIVAR, MISSISSIPPI, 38762
Obligated Amount 90413.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H80CS00085 Department of Health and Human Services 93.224 - CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, PUBLIC HOUSING PRIMARY CARE, AND SCHOOL BASED HEALTH CENTERS) 2001-12-01 2008-11-30 HEALTH CENTER CLUSTER
Recipient DELTA HEALTH CENTER, INC.
Recipient Name Raw DELTA HEALTH CENTER, INC
Recipient UEI GHKAM4REGNL9
Recipient DUNS 067718825
Recipient Address PO BOX 900, MOUND BAYOU, BOLIVAR, MISSISSIPPI, 38762
Obligated Amount 38876419.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
304314503 0419400 2002-06-18 1414 HOSPITAL STREET, GREENVILLE, MS, 38703
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2002-06-18
Case Closed 2002-11-06

Related Activity
Type Complaint
Activity Nr 202972964
Health Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 19101030 D04 IIIA2
Issuance Date 2002-07-26
Abatement Due Date 2002-08-01
Current Penalty 900.0
Initial Penalty 900.0
Nr Instances 1
Nr Exposed 4
Related Event Code (REC) Complaint
Gravity 02
Citation ID 01002
Citaton Type Serious
Standard Cited 19101030 F01 IIB
Issuance Date 2002-07-26
Abatement Due Date 2002-12-10
Current Penalty 900.0
Initial Penalty 900.0
Nr Instances 1
Nr Exposed 4
Related Event Code (REC) Complaint
Gravity 02
301029021 0419400 1996-12-04 860 HIGHWAY 1 NORTH, GREENVILLE, MS, 38703
Inspection Type Planned
Scope NoInspection
Safety/Health Safety
Close Conference 1996-12-04
Case Closed 1996-12-04

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
64-0443928 Corporation Unconditional Exemption 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS, 38762-9314 1968-01
In Care of Name -
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 Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2024-02
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Feb
Asset Amount 12690035
Income Amount 17354368
Form 990 Revenue Amount 17354368
National Taxonomy of Exempt Entities -
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)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name DELTA HEALTH CENTER INC
EIN 64-0443928
Tax Period 202302
Filing Type E
Return Type 990
File View File
Organization Name DELTA HEALTH CENTER INC
EIN 64-0443928
Tax Period 202202
Filing Type E
Return Type 990
File View File
Organization Name DELTA HEALTH CENTER INC
EIN 64-0443928
Tax Period 202002
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH CENTER INC
EIN 64-0443928
Tax Period 201902
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH CENTER INC
EIN 64-0443928
Tax Period 201802
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH CENTER INC
EIN 64-0443928
Tax Period 201702
Filing Type P
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3977177203 2020-04-27 0470 PPP 525 Hillcrest Cir, Cleveland, MS, 38732-2009
Loan Status Date 2021-06-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1303000
Loan Approval Amount (current) 1303000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 487365
Servicing Lender Name Hope Enterprise Corporation
Servicing Lender Address 4 Old River Place, Jackson, MS, 39202
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description New Business or 2 years or less
Project Address Cleveland, BOLIVAR, MS, 38732-2009
Project Congressional District MS-02
Number of Employees 112
NAICS code 621498
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Professional Association
Originating Lender ID 487365
Originating Lender Name Hope Enterprise Corporation
Originating Lender Address Jackson, MS
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 1316971.06
Forgiveness Paid Date 2021-05-27
4042158704 2021-03-31 0470 PPS 702 Martin Luther King St, Mound Bayou, MS, 38762-9314
Loan Status Date 2023-04-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1465550
Loan Approval Amount (current) 1465550
Undisbursed Amount 0
Franchise Name -
Lender Location ID 487365
Servicing Lender Name Hope Enterprise Corporation
Servicing Lender Address 4 Old River Place, Jackson, MS, 39202
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Mound Bayou, BOLIVAR, MS, 38762-9314
Project Congressional District MS-02
Number of Employees 117
NAICS code 621498
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Professional Association
Originating Lender ID 487365
Originating Lender Name Hope Enterprise Corporation
Originating Lender Address Jackson, MS
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 1494657.45
Forgiveness Paid Date 2023-04-06

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Date of last update: 13 Mar 2025

Sources: Mississippi Secretary of State

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