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CHALLIS AREA HEALTH CENTER, INCORPORATED

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Company Details

Name: CHALLIS AREA HEALTH CENTER, INCORPORATED
Jurisdiction: Idaho
Legal type: Non-Profit Corporation (D)
Status: Active-Good Standing
Date of registration: 27 Oct 2014 (11 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 614523
Place of Formation: IDAHO
File Number: 614523
ZIP code: 83226
County: Custer County
Mailing Address: SHARLENE MILLER PO BOX 980 CHALLIS, ID 83226-0980

Agent

Name Role Address
SHARLENE MILLER Agent 611 CLINIC RD, CHALLIS, ID 83226

President

Name Role Address Appointed On
J.D. Bennetts President 1225 CORRIGAN RD, CHALLIS, ID 83226 2020-10-07

Director

Name Role Address Appointed On Resigned On
Robert Boren Director HC 67 BOX 742, CLAYTON, ID 83226 2023-09-07 No data
Matt Cahoon Director 133 W SUMMIT CIRCLE, CHALLIS, ID 83226 2023-09-07 2023-09-07
Betsy Doughty Director PO BOX 103, CHALLIS, ID 83226 2023-09-07 2023-09-07
Jenness Butterfield Director PO BOX 87, CHALLIS, ID 83226 2023-09-07 2023-09-07
Shelbie Bryant Director PO BOX 1241, CHALLIS, ID 83226 2023-09-07 2023-09-07
Stephanie Strand Director PO BOX 1152, CHALLIS, ID 83226 2023-09-07 2023-09-07
Rayna Westergard Director PO BOX 100, CHALLIS, ID 83226 2023-09-07 No data

Vice President

Name Role Address Appointed On
Raynae Chamberlain Vice President 2200 FOOTHILLS RD, CHALLIS, ID 83226 2023-09-07

Secretary

Name Role Address Appointed On Resigned On
Corinne Jones Secretary 25491 HWY 93, CHALLIS, ID 83226 2023-09-07 2023-09-07

Treasurer

Name Role Address Appointed On Resigned On
Teila Leuzinger Treasurer PO BOX 271, CHALLIS, ID 83226 2023-09-07 2023-09-07

National Provider Identifier

NPI Number:
1013387877
Certification Date:
2020-07-21

Authorized Person:

Name:
SHARLENE MILLER
Role:
CFO
Phone:

Taxonomy:

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

Contacts:

Fax:
2088795216

Filing

Filing Name Filing Number Filing date
Annual Report 0005974542 2024-11-08
Annual Report 0005389616 2023-09-07
Annual Report 0004983166 2022-11-06
Annual Report 0004440528 2021-10-06
Annual Report 0004027697 2020-10-07

Tax Exempt

Employer Identification Number (EIN) :
47-3263272
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:
2014-10
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

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Date of last update: 15 May 2025

Sources: Idaho Secretary of State