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  5. THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC.

THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC.

Company Details

Name: THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 03 Jun 1998 (27 years ago)
Business ID: 657148
ZIP code: 39232
County: Rankin
State of Incorporation: MISSISSIPPI
Principal Office Address: 200 Park Circle, Suite 3Flowood, MS 39232

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
401K EMPLOYEE RETIREMENT PLAN 2023 640895372 2024-07-22 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 16
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2024-07-22
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2022 640895372 2023-07-21 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 13
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2023-07-21
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2021 640895372 2022-07-25 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 13
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2022-07-25
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2020 640895372 2021-07-28 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 18
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2019 640895372 2020-07-22 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 17
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2020-07-22
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2018 640895372 2019-07-29 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 14
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2017 640895372 2018-07-30 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 15
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2018-07-30
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2016 640895372 2017-07-05 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 20
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2017-07-05
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2015 640895372 2016-07-07 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 21
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
401K EMPLOYEE RETIREMENT PLAN 2014 640895372 2015-07-16 THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC. 22
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/15/20141015150926P040020591711001.pdf
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2014-10-15
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/31/20130731142225P040043632887001.pdf
Three-digit plan number (PN) 005
Effective date of plan 2012-07-01
Business code 813000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P O BOX 3303, RIDGELAND, MS, 391583303

Plan administrator’s name and address
Administrator’s EIN 452557054
Plan administrator’s name RETIREMENT PLAN SERVICES, LLC
Plan administrator’s address 4209 LAKELAND DRIVE, FLOWOOD, MS, 39232
Administrator’s telephone number 6019191023

Signature of
Role Plan administrator
Date 2013-07-31
Name of individual signing SCOTT HILL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/17/20111017114410P040695637728001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 611000
Sponsor’s telephone number 6013624720
Plan sponsor’s address P.O. BOX 3303, RIDGELAND, MS, 39158

Plan administrator’s name and address
Administrator’s EIN 640895372
Plan administrator’s name THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC.
Plan administrator’s address P.O. BOX 3303, RIDGELAND, MS, 39158
Administrator’s telephone number 6013624720

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing DARA BARIOLA
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role Address
D BRADLEY WALSH Incorporator 1216 VAN BUREN AVE, PO BOX 947, OXFORD, MS 38655

Agent

Name Role Address
Shelson, Sandra Agent 200 Park Circle , Suite 3, Flowood, MS 39232

Director

Name Role Address
Mike Moore Director PO Box 321048, FLowood, MS 39232
John McCullouch Director 114 Bridgeview Cir, Ridgeland, MS 39157
Hursie Sullivan MD Director 1814 Hospital Drive, Jackson, MS 39204
Richard deShazo MD Director 2564 Ashford pPace, Birmingham, AL 35243
Francine Katz Director 7914 Park Drive, St. Louis, MO 63117
V.O. Smith Director P.O.Box 635, Collins, MS 39428
Michael Thomas Director 1400 4th Ave, Jackson, MS 39296
George Abraham MD Director 604 South Main Street, Water Valley, MS 38965

President

Name Role Address
Mike Moore President PO Box 321048, FLowood, MS 39232

Chairman

Name Role Address
Mike Moore Chairman PO Box 321048, FLowood, MS 39232

Vice President

Name Role Address
John McCullouch Vice President 114 Bridgeview Cir, Ridgeland, MS 39157

Treasurer

Name Role Address
George Abraham MD Treasurer 604 South Main Street, Water Valley, MS 38965

Secretary

Name Role Address
Hursie Sullivan MD Secretary 1814 Hospital Drive, Jackson, MS 39204

Filings

Type Status Filed Date Description
Amendment Form Filed 2025-03-10 Amendment For THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC.
Agent Resignation Filed 2025-03-10 Agent Resignation For Bariola, Dara
Non-Profit Annual Report Filed 2025-03-10 Annual Report For THE PARTNERSHIP FOR A HEALTHY MISSISSIPPI, INC.
Amendment Form Filed 2007-07-13 Amendment
Amendment Form Filed 2005-02-09 Amendment
Name Reservation Form Filed 1998-06-03 Name Reservation

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
64-0895372 Corporation Unconditional Exemption 200 PARK CIRCLE DR STE 3, FLOWOOD, MS, 39232-7800 2000-02
In Care of Name % SANDRA SHELSON
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 2023-05
Asset 100,000 to 499,999
Income 500,000 to 999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period May
Asset Amount 447950
Income Amount 935390
Form 990 Revenue Amount 935390
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 PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 202305
Filing Type E
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 202205
Filing Type E
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 202105
Filing Type E
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 202005
Filing Type E
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 201905
Filing Type E
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 201805
Filing Type E
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 201705
Filing Type P
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 201605
Filing Type P
Return Type 990
File View File
Organization Name PARTNERSHIP FOR A HEALTHY MISSISSIPPI INC
EIN 64-0895372
Tax Period 201605
Filing Type P
Return Type 990
File View File

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Date of last update: 02 May 2025

Sources: Company Profile on Mississippi Secretary of State Website

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