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GENESIS COMMUNITY HEALTH, INC.

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Company Details

Name: GENESIS COMMUNITY HEALTH, INC.
Jurisdiction: Idaho
Legal type: Non-Profit Corporation (D)
Status: Active-Good Standing
Date of registration: 17 May 2001 (24 years ago)
Financial Date End: 31 May 2026
Entity Number: 424288
Place of Formation: IDAHO
File Number: 424288
ZIP code: 83714
County: Ada County
Mailing Address: 215 W 35TH ST GARDEN CITY, ID 83714-6520

Agent

Name Role Address
STEVE DAVIS Agent 215 W 35TH ST, GARDEN CITY, ID 83714

Treasurer

Name Role Address Appointed On Resigned On
Lori Turner Treasurer 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09 2024-05-09

Secretary

Name Role Address Appointed On Resigned On
Kyle Rooks Secretary 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09 2024-05-09

President

Name Role Address Appointed On Resigned On
Perry Jansen President 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2023-04-03 No data
Jackelyn Jantzi President 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2021-08-20 2023-04-03

Director

Name Role Address Appointed On Resigned On
Dave Irving Director 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09 2024-05-09
Ryan Rebishke Director 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09 No data
Dale Dixon Director 215 W 35TH ST, GARDEN CITY, ID 83714 2024-05-09 2024-05-09
Nikki Zogg Director 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09 2024-05-09
Karl Watts Director 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09 2024-05-09
Lori Turner Director 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2025-04-10 No data

Vice President

Name Role Address Appointed On
Jeffrey Greene Vice President 215 W 35TH ST, GARDEN CITY, ID 83714-6520 2024-05-09

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:
VGPFJTKXQFJ3
CAGE Code:
88GR7
UEI Expiration Date:
2026-01-08

Business Information

Doing Business As:
GARDEN CITY COMMUNITY CLINIC
Division Name:
GENESIS COMMUNITY HEALTH, INC.
Activation Date:
2025-01-10
Initial Registration Date:
2019-01-22

National Provider Identifier

NPI Number:
1548783160

Authorized Person:

Name:
JOSH CAMPBELL
Role:
OPERATIONS DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
251V00000X - Voluntary or Charitable Agency
Is Primary:
Yes

Contacts:

Fax:
2083845205

Filing

Filing Name Filing Number Filing date
Annual Report 0006204236 2025-04-10
Annual Report 0005732591 2024-05-09
Annual Report 0005176359 2023-04-03
Annual Report 0004687166 2022-04-04
Application for Reinstatement 0004389606 2021-08-20

USAspending Awards / Financial Assistance

Date:
2020-04-15
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:
88000.00
Total Face Value Of Loan:
88000.00

Tax Exempt

Employer Identification Number (EIN) :
82-0505073
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:
2001-12
National Taxonomy Of Exempt Entities:
International, Foreign Affairs and National Security: International Relief
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
88000
Current Approval Amount:
88000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
88911.34

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Date of last update: 05 Jun 2025

Sources: Idaho Secretary of State