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  5. DELTA HEALTH ALLIANCE, INC.

DELTA HEALTH ALLIANCE, INC.

Company Details

Name: DELTA HEALTH ALLIANCE, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 13 Dec 2001 (23 years ago)
Business ID: 710435
ZIP code: 38776
County: Washington
State of Incorporation: MISSISSIPPI
Principal Office Address: 435 Stoneville RoadStoneville, MS 38776

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DELTA HEALTH ALLIANCE, INC. 401(K) RETIREMENT PLAN 2017 470915576 2018-10-08 DELTA HEALTH ALLIANCE, INC. 85
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2018-10-07
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-07
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. 401(K) RETIREMENT PLAN 2017 470915576 2018-10-29 DELTA HEALTH ALLIANCE, INC. 0
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2018-10-29
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-29
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. RETIREMENT PLAN 2017 470915576 2018-10-08 DELTA HEALTH ALLIANCE, INC. 76
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2018-10-07
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-07
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. RETIREMENT PLAN 2016 470915576 2017-10-02 DELTA HEALTH ALLIANCE, INC. 85
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2017-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. 401(K) RETIREMENT PLAN 2016 470915576 2017-10-02 DELTA HEALTH ALLIANCE, INC. 51
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2017-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. 401(K) RETIREMENT PLAN 2015 470915576 2016-09-30 DELTA HEALTH ALLIANCE, INC. 38
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2016-09-30
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-30
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. RETIREMENT PLAN 2015 470915576 2016-09-30 DELTA HEALTH ALLIANCE, INC. 99
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626867004
Plan sponsor’s address 435 STONEVILLE ROAD, LELAND, MS, 38756

Signature of
Role Plan administrator
Date 2016-09-30
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-30
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. 401(K) RETIREMENT PLAN 2014 470915576 2015-10-02 DELTA HEALTH ALLIANCE, INC. 52
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Signature of
Role Plan administrator
Date 2015-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. RETIREMENT PLAN 2014 470915576 2015-10-02 DELTA HEALTH ALLIANCE, INC. 51
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Signature of
Role Plan administrator
Date 2015-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-02
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
DELTA HEALTH ALLIANCE, INC. RETIREMENT PLAN 2013 470915576 2014-10-10 DELTA HEALTH ALLIANCE, INC. 40
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/12/22/20141222160130P030017963457001.pdf
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/12/22/20141222155936P040012560599001.pdf
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/27/20130927103459P040000618567001.pdf
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing KIM DANG - AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/27/20130927103219P040000617623001.pdf
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing KIM DANG - AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/16/20120916083703P030006184740001.pdf
Three-digit plan number (PN) 004
Effective date of plan 2011-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915576
Plan administrator’s name DELTA HEALTH ALLIANCE, INC.
Plan administrator’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2012-09-16
Name of individual signing KIM DANG - AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/16/20120916084144P030003453173001.pdf
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915576
Plan administrator’s name DELTA HEALTH ALLIANCE, INC.
Plan administrator’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2012-09-16
Name of individual signing KIM DANG - AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/20/20110920162548P040137042705001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915576
Plan administrator’s name DELTA HEALTH ALLIANCE, INC.
Plan administrator’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2011-09-20
Name of individual signing KIM DANG AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/20/20110920163415P030133782305001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915576
Plan administrator’s name DELTA HEALTH ALLIANCE, INC.
Plan administrator’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2011-09-20
Name of individual signing KIM DANG AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/21/20110921065707P030134123729001.pdf
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915576
Plan administrator’s name DELTA HEALTH ALLIANCE, INC.
Plan administrator’s address 435 STONEVILLE ROAD, STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2011-09-21
Name of individual signing KIM DANG AS PRACTITIONER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/09/20100909104303P040487946545001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE RD., STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915546
Plan administrator’s name DELTA HEALTH ALLIANCE INC.
Plan administrator’s address 435 STONEVILLE RD., STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2010-09-09
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/09/20100909104203P040050099651001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 6626863520
Plan sponsor’s address 435 STONEVILLE RD., STONEVILLE, MS, 38776

Plan administrator’s name and address
Administrator’s EIN 470915576
Plan administrator’s name DELTA HEALTH ALLIANCE INC.
Plan administrator’s address 435 STONEVILLE RD., STONEVILLE, MS, 38776
Administrator’s telephone number 6626863520

Signature of
Role Plan administrator
Date 2010-09-09
Name of individual signing HENRY WOMACK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Henry marlin womack Junior Agent 435 Stoneville Road, Leland, MS 38756

Incorporator

Name Role Address
MELVIN V PRIESTER Incorporator 371 EDGEWOOD TERRACE DRIVE, JACKSON, MS 39206

President

Name Role Address
Karen C. Matthews President 641 South McLean, Memphis, TN 38104

Chief Executive Officer

Name Role Address
Karen C. Matthews Chief Executive Officer 641 South McLean, Memphis, TN 38104

Vice President

Name Role Address
Henry Marlin Womack Jr Vice President 119 Lilac Drive, Leland, MS 38756
Brooks Ann Gaston Vice President 105 Williamsburg cove, oxford, MS 38655

Chief Financial Officer

Name Role Address
Henry Marlin Womack Jr Chief Financial Officer 119 Lilac Drive, Leland, MS 38756

Director

Name Role Address
Lisa Percy Director 134 Bayou Road, Greenville, MS 38701
William Kennedy Director 13 Kennedy Rd., Inverness, MS 38753
Willie Bailey Director 218 Theobald St., Greenville, MS 38701
Woods Eastland Director 1304 Bayou Drive, Indianola, MS 38751
Myrtis Tabb Director 1311 College St., Cleveland, MS 38732
Joyce McNair Director 512 Holmes St., Belzoni, MS 39038
Randy Easterling MD Director P. O. Box 690, Vicksburg, MS 39180
Joe Nash Director 1325 Olive, Jackson, MS 39202
Don Green Director P. O. Box 1414, Clarksdale, MS 38614

Secretary

Name Role Address
Lisa Percy Secretary 134 Bayou Road, Greenville, MS 38701

Chairman

Name Role Address
William Kennedy Chairman 13 Kennedy Rd., Inverness, MS 38753

Filings

Type Status Filed Date Description
Non-Profit Status Report Filed 2024-04-11 Status Report For DELTA HEALTH ALLIANCE, INC.
Amendment Form Filed 2021-03-01 Amendment For DELTA HEALTH ALLIANCE, INC.
Non-Profit Status Report Filed 2021-01-28 Status Report For DELTA HEALTH ALLIANCE, INC.
Non-Profit Status Report Filed 2020-05-18 Status Report For DELTA HEALTH ALLIANCE, INC.
Non-Profit Status Report Filed 2019-07-03 Status Report For DELTA HEALTH ALLIANCE, INC.
Amendment Form Filed 2011-02-01 Amendment
Amendment Form Filed 2002-12-10 Amendment
Name Reservation Form Filed 2001-12-13 Name Reservation

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
58-6401-1-642-0 Department of Agriculture 10.001 - AGRICULTURAL RESEARCH_BASIC AND APPLIED RESEARCH 2011-09-30 2016-09-30 DELTA HUMAN NUTRITION AND OBESITY PREVENTION
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address P. O. BOX 277, 435 STONEVILLE RD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 97561.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
RO45837 19903 Department of Agriculture 10.874 - DELTA HEALTH CARE SERVICES GRANT PROGRAM 2011-09-26 2013-09-26 DELTA HEALTH CARE SERVICES GRANT - CONACT SEC 379G
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 15660.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H9CRH22858 Department of Health and Human Services 93.912 - RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT PROGRAM 2011-09-01 2014-08-31 RURAL HIT NETWORK PROGRAM
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 899946.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
58-6251-1-049-1 Department of Agriculture 10.001 - AGRICULTURAL RESEARCH_BASIC AND APPLIED RESEARCH 2011-05-01 2012-06-30 DELTA OBESITY PREVENTION RESEARCH - DELTA HEALTH ALLIANCE
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE RD, PO BOX 277, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 92000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
58-6251-1-049-0 Department of Agriculture 10.001 - AGRICULTURAL RESEARCH_BASIC AND APPLIED RESEARCH 2011-05-01 2012-06-30 DELTA OBESITY PREVENTION RESEARCH - DELTA HEALTH ALLIANCE
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE RD, PO BOX 277, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 150000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
U215P100281 Department of Education 84.215 - FUND FOR THE IMPROVEMENT OF EDUCATION 2010-10-01 2011-09-30 PROMISE NEIGHBORHOODS
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STNVILLE RD BLDG 1585, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 332531.00
Non-Federal Funding 286750.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
90BC0004 Department of Health and Human Services 93.727 - ARRA - HEALTH INFORMATION TECHNOLOGY - BEACON COMMUNITIES 2010-04-01 2013-03-31 BETTER LIVING UTILIZING ELECTRONIC SYSTEMS (BLUES) BEACON COMMUNITY PROJECT - ADVANCING MEANINGFUL EHR ADOPTION AND HIE
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 14666156.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
RO21209 12641 Department of Agriculture 10.855 - DISTANCE LEARNING AND TELEMEDICINE LOANS AND GRANTS 2009-09-30 2011-09-30 TELEMEDICINE GRANT
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient DUNS 014085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 0.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H2AIT16626 Department of Health and Human Services 93.211 - TELEHEALTH PROGRAMS 2009-09-01 2012-08-31 TELEHEALTH NETWORK GRANT PROGRAM
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 582466.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
D04RH12672 Department of Health and Human Services 93.912 - RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT PROGRAM 2009-05-01 2012-04-30 RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 375000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776
Obligated Amount 714856.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776, UNITED STATES
Obligated Amount 2871227.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, P. O. BOX 277, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 43902.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, P. O. BOX 277, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 25000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, P. O. BOX 277, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277, UNITED STATES
Obligated Amount 17366.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, P. O. BOX 277, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776-0277
Obligated Amount 34000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
Recipient DELTA HEALTH ALLIANCE, INC.
Recipient Name Raw DELTA HEALTH ALLIANCE, INC.
Recipient UEI TCEDH41KB163
Recipient DUNS 148085868
Recipient Address 435 STONEVILLE ROAD, STONEVILLE, WASHINGTON, MISSISSIPPI, 38776
Obligated Amount 83408000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
47-0915576 Corporation Unconditional Exemption 435 STONEVILLE ROAD, STONEVILLE, MS, 38776-0000 2004-02
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 Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-06
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 Jun
Asset Amount 27371453
Income Amount 37178547
Form 990 Revenue Amount 37178547
National Taxonomy of Exempt Entities Medical Research: Fund Raising and/or Fund Distribution
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 ALLIANCE INC
EIN 47-0915576
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 202006
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 201906
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 201806
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 201706
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 201606
Filing Type P
Return Type 990
File View File
Organization Name DELTA HEALTH ALLIANCE INC
EIN 47-0915576
Tax Period 201606
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
5532377004 2020-04-05 0470 PPP 435 STONEVILLE ROAD, STONEVILLE, MS, 38776-9700
Loan Status Date 2022-03-26
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2728500
Loan Approval Amount (current) 2728500
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39763
Servicing Lender Name Planters Bank & Trust Company
Servicing Lender Address 212 Catchings Ave, INDIANOLA, MS, 38751-2408
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address STONEVILLE, WASHINGTON, MS, 38776-9700
Project Congressional District MS-02
Number of Employees 334
NAICS code 813219
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 39763
Originating Lender Name Planters Bank & Trust Company
Originating Lender Address INDIANOLA, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2759971.19
Forgiveness Paid Date 2021-06-09

Court Cases

Docket Number Nature of Suit Filing Date Disposition
2300173 Civil Rights Employment 2023-09-07 settled
Circuit Fifth Circuit
Origin original proceeding
Jurisdiction federal question
Jury Demand Both plaintiff and defendant demand jury
Demanded Amount 0
Termination Class Action Missing
Procedural Progress pretrial conference held
Nature Of Judgment no monetary award
Judgement missing
Arbitration On Termination Missing
Office 4
Filing Date 2023-09-07
Termination Date 2024-05-20
Date Issue Joined 2023-10-16
Section 1331
Status Terminated

Parties
Name JOHNSON
Role Plaintiff
Name DELTA HEALTH ALLIANCE, INC.
Role Defendant
1500058 Social Security - RSI (405(g)) 2015-05-11 other
Circuit Fifth Circuit
Origin original proceeding
Jurisdiction US government defendant
Jury Demand Neither plaintiff nor defendant demands jury
Demanded Amount 0
Termination Class Action Missing
Procedural Progress other
Nature Of Judgment no monetary award
Judgement missing
Arbitration On Termination Missing
Office 4
Filing Date 2015-05-11
Termination Date 2017-08-16
Date Issue Joined 2015-11-03
Section 0405
Sub Section WW
Status Terminated

Parties
Name DELTA HEALTH ALLIANCE, INC.
Role Plaintiff
Name BURWELL,
Role Defendant
1600123 Social Security - RSI (405(g)) 2016-06-15 voluntarily
Circuit Fifth Circuit
Origin original proceeding
Jurisdiction US government defendant
Jury Demand Neither plaintiff nor defendant demands jury
Demanded Amount 0
Termination Class Action Missing
Procedural Progress no court action
Nature Of Judgment no monetary award
Judgement missing
Arbitration On Termination Missing
Office 4
Filing Date 2016-06-15
Termination Date 2016-09-29
Section 1395
Status Terminated

Parties
Name DELTA HEALTH ALLIANCE, INC.
Role Plaintiff
Name BURWELL,
Role Defendant

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No related companies by address

Date of last update: 19 Mar 2025

Sources: Mississippi Secretary of State

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