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TYPE AGENCY NAMEAGENCY ADDRESSAGENCY CITYAGENCY STATEZIPAgency Phone NumberAgency Fax NumberAGENCY E-MAIL ADDRESSPROGRAM NAMEPROGRAM VENDOR NUMBERPROGRAM SITE ADDRESSPROGRAM CITYPROGRAM STATEPROGRAM ZIPPROGRAM PHONE # (Exp: 7775551111)PROGRAM FAX # (Exp: 7705552222)PROGRAM E-MAIL ADDRESSDates of Operation Start DateDates of Operation End DateDays in OperationHouse Parent StructureHardware SecureCCIMaternitySecond ChanceTeen DevelopmentCampSpecialized Residential (DJJ)Other (Specify)Private Non-ProfitPrivate For-ProfitPublicAverage Number of Foster Homes Available During the Year CPAAverage Number of Foster Home Beds Available During the Year CPANumber Of Foster Homes Added During the Year CPANumber Of Foster Homes Lost During the Year CPANumber of Foster Beds Added During the Year CPANumber of Foster Beds Lost During the Year CPALicensed Capacity of Parent Agency CCILicensed Capacity of this Program CCIMaximum Capacity of this Program (if less than licensed capacity)*** CCINumber of Months Operational during Reporting Period CCITOTAL UNDUPLICATED CHILDRENTOTAL BED DAYSTOTAL ADJUSTED BED DAYSCCI Utilization FactorTotal SalariesTotal BenefitsTotal Salaries and BenefitsTotal Benefits %TOTAL Contract ExpenseTOTAL ConsumablesIndirect Agency ExpenseIndirect As a Percentage of Total ExpenseA. Mortgage InterestB. Rent/LeaseC. Building InsuranceD. UtilitiesE. Property TaxF. SecurityG. Maintenance & RepairGH Other (Must Specify): >>>Total OccupancyMaintenance & Repair as A Percentage of Total OccupancyA. Purchased Transportation For ClientB. Agency Vehicle Operating CostC. Agency Vehicle InsuranceD. Staff Mileage Reimbursement - NON Traning Related (see Comsumables Line Item "Q")D. Staff Mileage D. Per Mile Reimbursement E. Transportation Rental F. Other (Must Specify) >> Total TravelA. Vehicle/Equip. Loan InterestB. Rental & Maintenance of Equipment (Not Vehicle)C. Vehicle LeaseD. Depreciated EquipmentTotal EquipmentTotal Other ExpenseDirect paid USDA/school lunch/food subsidyOther Federal (e.g., Emergency Shelter Grants, SSI payments, etc.) - must specify >>> DFCS reimbursements non-perdiemPrivate, etc.TOTAL Traditional RevenueTOTAL Base WO RevenueTotal MAX WO RevenueTotal SBWO RevenueTotal SMWO RevenueTotal SMFWO RevenueTotal PFCM RevenueADD ALL OTHER PER DIEM REVENUE J20 from RevenueTOTAL Base RevenueTOTAL AWO RevenueTOTAL MWO RevenueTOTAL 2nd Chance RevenueTOTAL Maternity RevenueTOTAL Teen DevelopmentTOTAL Camp Revenue
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CCIAdvocates for Bartow's Children, Inc.49 Monroe Crossing (P. O. Box 446)CartersvilleGA 30,120 77038711437706060732steve@advochild.orgFlowering Branch Children's Shelter417246490 Monroe CrossingCartersvilleGA 30,120 77038711437706060732steve@advochild.org1/1/201112/31/2011365 0 0 x 0 0 0 0 0 0 x 0 0 12 12 12 12.0 33 3,419 3,504 78.06%$475,738 $58,467 $534,205 12.29%$25,208 $87,509 $0 0.0%$0 $0 $0 $28,994 $0 $2,995 $8,034 $0 $40,023 20.07%$0 $6,251 $2,902 $9,976 21458$0.4650 $0 $0 $19,129 $0.00 $7,464.00 $0.00 $0.00 $7,464.00 $66,616.00 $0$190,320$5,481$191,873$1,058 $324,806 $0 $0 $0 $0$0$0
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CCIALYSSA AND BROTHER, INC DBA ROWLEY RESIDENCE5214 GREENPOINT DRIVESTONE MOUNTAINGA 30,088 678-570-8731770-498-4191STAFF@ROWLEYRESIDENCE.ORGALYSSA AND BROTHERS, INC DBA ROWLEY RESIDENCE #2352554552 DORSET CIRCLEDECATURGA 30,035 678-518-8633770-498-4191STAFF@ROWLEYRESIDENCE.ORG1/1/201112/31/2011365YNX 0 0 0 0 0 0 X 0 0 12 6 6 12.0 117 1,969 1,969 89.91%$102,755 $6,304 $109,059 6.13%$11,456 $41,098 $0 0.0%$0 $21,885 $0 $4,594 $0 $0 $1,399 $58 $27,936 5.01%$0 $7,054 $0 Requires entry into Cell H31 if claiming expense0$5,014 $0 $12,068 $0.00 $0.00 $0.00 $153.00 $153.00 $40,157.00 $0$0$0$11,262$0 $190,270 $0 $0 $0 $0$0$0
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CPABenchmark Family Services, Inc.127 Quick RoadNew CarlisleOH 45,344 93784510709378451168beth.hanrahan@adminsolutionsinc.comBenchmark Family Services, Inc.354454330 Gilbert AveColumbusGA 31,904 70640542567065769997beth.hanrahan@adminsolutionsinc.com12/1/20106/30/2011212x 0 x 0 0 19 42 20 1 46 1 7.0 32 3,849 43.00%$124,326 $21,727 $146,053 17.48%$149,870 $16,856 $47,377 12.1%$0 $23,295 $0 $3,550 $0 $0 $668 $0 $27,513 2.43%$0 $0 $0 $2,867 8,191 $0.35 $0 $181 $3,048 $0 $1,299 $0 $0 $1,299 $31,860$0$0$2,700$0$15,620$76,240$141,590$20,430$26,288$0$0$0
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CPABenchmark Family Services, Inc.127 Quick RoadNew CarlisleOH 45,344 93784510709378451168beth.hanrahan@adminsolutionsinc.comBenchmark Family Services, Inc.354451003 Virginia Ave., Suite 210HapevilleGA 30,354 77021087457704710651beth.hanrahan@adminsolutionsinc.com7/1/20106/30/2011365x 0 x 0 0 19 46 16 13 42 40 12.0 76 8,105 48.00%$201,609 $34,810 $236,419 17.27%$264,209 $52,414 $103,126 14.6%$0 $32,300 $497 $74 $0 $0 $194 $0 $33,065 0.59%$0 $111 $0 $9,133 26,094 $0.35 $0 $5,850 $15,094 $0 $2,641 $0 $446 $3,087 $51,246$0$0$9,300$0$59,307$197,519$227,066$0$20,088$0$0$0
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CPABenchmark Family Services, Inc.127 Quick RoadNew CarlisleOH 45,344 93784510709378451168beth.hanrahan@adminsolutionsinc.comBenchmark Family Services, Inc.354452080 Sugarloaf Parkway, Suite 120LawrencevilleGA 30,045 77033808007703382219beth.hanrahan@adminsolutionsinc.com12/1/20106/30/2011212x 0 x 0 0 12 26 12 0 28 0 7.0 43 2,730 50.00%$57,116 $7,573 $64,689 13.26%$109,592 $17,639 $21,645 9.4%$0 $10,500 $0 $1,936 $0 $0 $380 $0 $12,816 2.97%$0 $0 $0 $3,634 10,383 $0.35 $0 $0 $3,634 $0 $1,192 $0 $0 $1,192 $17,642$0$0$0$0$7,815$35,926$159,482$0$1,860$0$0$0
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CPABethany Christian Services6645 Peachtree Dunwoody Road, NEAtlantaGeorgia 30,328 77045571117702743460www.bethany.orgFoster Care Atlanta352496645 Peachtree Dunwoody Road, NEAtlantaGeorgia 30,328 77045571117702743460www.bethany.org1/1/201112/31/2011365X 0 X 0 0 83 238 18 25 42 0 12.0 205 29,974 35.00%$453,786 $157,204 $610,990 34.64%$1,109,464 $115,590 $103,711 5.0%$0 $45,001 $2,437 $8,385 $7,456 $0 $14,193 $855 $78,327 18.12%$314 $6,454 $5,215 $29,384 61,217 $0.48 $1,544 $3,759 $46,670 $0 $11,118 $0 $2,466 $13,584 $138,581$0$0$0$2,765$435,832$716,244$349,482$0$209,786$319,154$0$210,915
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CPABethany Christian Services5050 Warm Spring Road, Suite 200-BColumbusGeorgia 31,909 70657657667065765159www.bethany.orgFoster Care Columbus352485050 Warm Spring Road, Suite 200BColumbusGeorgia 31,909 70657657667065765159www.bethany.org1/1/201112/31/2011365X 0 X 0 0 9 31 3 6 16 18 12.0 27 2,931 26.00%$55,173 $18,445 $73,618 33.43%$55,362 $8,535 $11,689 7.3%$0 $4,402 $153 $884 $4 $0 $1,146 $0 $6,589 17.39%$0 $0 $0 $2,166 4,522 $0.48 $788 $1,687 $4,641 $0 $201 $0 $331 $532 $11,762$0$0$0$160$54,902$72,301$0$0$0$0$0$2,747
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CCICarrie Steele-Pitts Home, Inc.667 Fairburn Road, NWAtlanta,Georgia 30,331 40469654584046965459csph1888@aol.comCarrie Steele-Pitts Home, Inc.35258667 Fairburn Road,NWAtlanta, Georgia 30,331 40469654584046965459csph1888@aol.com7/1/20106/30/2011365ynx 0 0 0 0 0 0 x 0 0 100 56 56 12.0 61 7,368 16,352 36.05%$769,663 $267,634 $1,037,296 34.77%$14,281 $334,297 $0 0.0%$0 $0 $13,205 $167,906 $0 $0 $57,585 $0 $238,696 24.12%$0 $20,367 $7,463 $5,015 8358.33$0.6000 $0 $0 $32,845 $0.00 $4,157.00 $0.00 $236,858.00 $241,015.00 $512,555.27 $17,143$0$0$442,892$430,719 $747,499 $0 $0 $0 $0$0$0
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CPAChildkind, Inc.3107 Clairmont Road, Suite AAtlantaGA 30,329 40424819804042481981tclymore@childkind.orgChildkind, Inc.4169033107 Clairmont Road, Suite AAtlantaGA 30,329 40424819804042481981tclymore@childkind.org1/1/201112/31/2011365X 0 X 0 0 62 123 25 8 75 24 12.0 179 26,151 58.00%$816,427 $193,770 $1,010,197 23.73%$1,420,406 $119,568 $0 0.0%$0 $44,956 $0 $7,952 $0 $103 $0 $0 $53,011 0.00%$0 $0 $0 $42,463 88,926 $0.48 $0 $595 $43,058 $0 $4,929 $0 $9,218 $14,147 $110,216$0$3,500$27,597$5,653$15,594$344,580$324,685$169,845$300,705$1,589,888$0$0
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CCIChristian City Home for Children7345 Red Oak RoadUnion CityGeorgia 30,291 77096433090 0 Christian City Home for Children352847345 Red Oak RoadUnion CityGeorgia 30,291 77096433090 0 7/1/20106/30/2011365YNX 0 0 0 0 0 0 X 0 0 62 48 48 12.0 40 9,121 14,016 52.06%$670,566 $179,439 $850,005 26.76%$144,640 $214,826 $0 0.0%$0 $4,512 $13,890 $98,856 $1,816 $25,171 $17,011 $0 $161,256 10.55%$0 $56,363 $939 $206 412$0.5000 $0 $0 $57,508 $0.00 $0.00 $0.00 $0.00 $0.00 $218,763.53 $0$0$0$1,997,958$23,054 $95,264 $0 $0 $0 $0$0$0
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CPACreative Community Services4487 Park Drive, Suite ANorcrossGeorgia 30,093 77046962267704696210sbuchanan@ccsgeorgia.orgTherapeutic Foster Care (TFC) 416,907 4487 Park Drive, Suite ANorcrossGeorgia 30,093 7,704,696,226 7,704,696,210 sbuchanan@ccsgeorgia.org7/1/20106/30/2011365 0 X 0 0 80 136 11 8 22 10 12.0 66 14,798 $687,737 $223,319 $911,055 32.47%$973,538 $191,797 $0 0.0%$0 $61,925 $0 $14,209 $0 $0 $3,034 $0 $79,168 3.83%$0 $17,899 $4,750 $82,402 257,506 $0.32 $0 $0 $105,051 $0 $15,971 $0 $0 $15,971 $200,190$0$0$44,768$0$0$0$0$11,070$2,055,447$59,495$0$0
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CPAThe Devereux Foundation - Georgia Treatment NetworkPO Box 490AVillanovaPA 19,085 61054230786105423140ljohnso2@devereux.orgDevereux Georgia Treatment Network - Foster CareNA1291 Stanley Road NWKennesawGeorgia 30,152 6,783,032,651 7,704,231,502 www.devereux.org7/1/20106/30/2011365 0 x 0 0 31 50 7 2 15 5 12.0 83 15,132 $292,396 $93,845 $386,241 32.10%$662,232 $89,181 $45,754 3.7%$0 $0 $0 $141 $0 $0 $1,703 $0 $1,844 92.35%$0 $2,179 $369 $16,892 33,784 $0.50 $0 $0 $19,440 $0 $7,314 $0 $10,966 $18,280 $39,564$0$0$0$5,045$50,335$356,466$439,180$136,177$282,521$0$0$4,748
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CCIThe Devereux Foundation - Georgia Treatment NetworkPO Box 490AVillanovaPA 19,085 61054230786105423140ljohnso2@devereux.orgDevereux Georgia Treatment Network - Project PlusNA2740 Tiffany DriveMariettaGeorgia 30,008 6,783,032,651 7,704,231,502 www.devereux.org7/1/20106/30/2011365YY 0 0 0 X 0 0 0 X 0 0 0 8 8 12.0 16 2,750 2,750 94.18%$300,657 $86,352 $387,009 28.72%$7,806 $40,580 $19,531 4.0%$0 $0 $0 $9,151 $103 $0 $4,358 $0 $13,612 32.02%$0 $14,520 $1,456 $135 270$0.5000 $0 $0 $16,111 $0.00 $886.00 $4,477.00 $0.00 $5,363.00 $35,086.00 $0$0$0$8,616$165 $0 $0 $450,945 $0 $0$0$0
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CCIEMBRACING ARMS, INC1673 HEARTSTONE COURTJONESBOROGA 30,236 77047725516786233748kunderdue@embracing-arms.comEmbracing Arms, IncCCI0013561673 Hearthstone CourtJonesboroGA 30,236 7,704,772,551 6,786,233,748 kunderdue@embracing-arms.com1/1/201112/31/2011365NNx 0 0 0 0 0 0 0 x 0 6 6 6 12.0 35 1,891 1,891 86.35%$92,495 $12,396 $104,891 13.40%$68,107 $36,366 $0 0.0%$0 $11,400 $200 $4,635 $0 $386 $11,264 $0 $27,885 40.39%$0 $5,024 $3,600 Requires entry into Cell H31 if claiming expense0$0 $0 $8,624 $0.00 $2,713.00 $0.00 $0.00 $2,713.00 $39,222.00 $0$0$0$0$8,349 $45,717 $153,872 $30,368 $0 $0$0$0
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CPAENA, Inc (dba Necco)503 Darby Creek RoadLexingtonKY 40,509 740-313-0388740-313-0428smullins@necco.orgNECCO-Albany 84,512 2231 Dawson Road, Suite UAlbanyGA 31,707 2,298,898,884 2,298,898,875 jamos@necco.org7/1/20106/30/2011365X 0 X 0 0 18 36 17 24 34 48 12.0 59 9,615 73.00%$190,787 $31,862 $222,649 16.70%$475,361 $39,349 $0 0.0%$0 $42,686 $657 $3,982 $0 $0 $1,204 $0 $48,529 2.48%$0 $584 $600 $4,840 9,490 $0.51 $0 $0 $6,024 $0 $436 $182 $0 $618 $55,171$0$0$2,238$21,739$2,213$259,118$502,652$810$14,632$0$0$0
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CPAENA, Inc (dba Necco)503 Darby Creek RoadLexingtonKY 40,509 740-313-0388740-313-0428smullins@necco.orgNECCO-Augusta 84,510 4424 Columbia Road, Suite BMartinezGA 30,907 7,062,103,435 7,062,109,953 jamos@necco.org7/1/20106/30/2011365X 0 X 0 0 34 68 30 26 60 54 12.0 80 17,150 69.00%$282,453 $47,169 $329,622 16.70%$986,970 $59,939 $0 0.0%$0 $37,435 $1,224 $8,682 $0 $0 $2,680 $0 $50,021 5.36%$0 $3,909 $1,119 $10,765 21,108 $0.51 $0 $0 $15,793 $0 $814 $339 $0 $1,153 $66,967$0$0$2,050$7,795$50,478$206,370$1,091,400$0$52,452$59,495$0$0
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CPAENA, Inc (dba Necco)503 Darby Creek RoadLexingtonKY 40,509 74031303887403130428smullins@necco.orgNECCO-Jonesboro 84,514 9556 Tara Boulevard, Suite 400JonesboroGA 30,236 6,786,101,933 6,786,101,633 jamos@necco.org7/1/20106/30/2011365X 0 X 0 0 13 26 16 0 32 0 12.0 81 12,049 127.00%$164,611 $27,490 $192,101 16.70%$494,698 $36,746 $0 0.0%$0 $30,523 $709 $7,415 $0 $0 $4,510 $0 $43,157 10.45%$0 $666 $648 $5,287 10,367 $0.51 $0 $0 $6,601 $0 $472 $197 $0 $669 $50,427$0$0$1,354$170$0$252,525$577,789$0$372$0$0$88,336
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CPAENA, Inc (dba Necco)503 Darby Creek RoadLexingtonKY 40,509 74031303887403130428smullins@necco.orgNECCO-Macon 84,513 150 North Crest BoulevardMaconGA 31,210 4,782,542,902 4,782,543,031 jamos@necco.org7/1/20106/30/2011365X 0 X 0 0 66 122 45 72 90 144 12.0 132 20,015 45.00%$339,136 $56,637 $395,773 16.70%$1,065,744 $98,672 $0 0.0%$0 $90,734 $1,404 $11,950 $0 $0 $11,770 $0 $115,858 10.16%$0 $3,174 $1,283 $21,652 42,455 $0.51 $0 $0 $26,109 $0 $1,566 $908 $0 $2,474 $144,441$0$0$6,864$7,799$79,194$488,817$692,372$39,780$307,776$0$0$0
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CPAFAITHBRIDGE FOSTER CARE, INC.2655 NORTHWINDS PARKWAYALPHARETTAGA 30,009 00 0 FAITHBRIDGE FOSTER CARE, INC.427-93-09090803-992655 NORTHWINDS PARKWAYALPHARETTAGA 30,009 0 0 0 1/1/201112/31/2011365X 0 X 0 0 90 120 35 38 70 50 12.0 145 23,359 53.00%$787,468 $72,170 $859,638 9.16%$689,506 $160,023 $0 0.0%$0 $61,168 $0 $8,675 $0 $0 $0 $0 $69,843 0.00%$0 $69,530 $9,383 Requires entry into Cell H30 if claiming expense 0 $0 $1,989 $80,902 $0 $21,083 $119,871 $26,447 $167,401 $318,146$0$0$29,786$1,971,961$0$1,133,889$0$0$0$0$0$0
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CCIFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgCherokee Group Home416915809 Cherokee Ave.AtlantaGA 30,316 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365part of yearNX 0 0 0 0 0 0 X 0 0 45 7 7 12.0 11 1,852 2,044 72.49%$171,080 $21,906 $192,986 12.80%$4,991 $31,045 $0 0.0%$0 $0 $3,259 $16,866 $0 $0 $13,906 $0 $34,031 40.86%$0 $7,172 $1,750 $1,869 3701$0.5050 $0 $0 $10,791 $0.00 $3,329.00 $7,298.00 $0.00 $10,627.00 $55,449.20 $0$0$0$32,142$0 $188,571 $0 $0 $0 $0$0$0
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CCIFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgGwindale Group Home4173112176 Ridgedale Dr.GraysonGA 30,221 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365YNX 0 0 0 0 0 0 X 0 0 45 7 7 12.0 15 1,381 2,044 54.05%$149,100 $22,039 $171,139 14.78%$4,194 $27,857 $0 0.0%$0 $0 $890 $7,705 $0 $0 $11,381 $0 $19,976 56.97%$0 $6,286 $1,576 $608 1204$0.5050 $0 $0 $8,470 $0.00 $2,816.00 $3,130.00 $0.00 $5,946.00 $34,391.70 $0$0$0$24,000$0 $140,613 $0 $0 $0 $0$0$0
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CCIFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgMorris Road Group Home4173102345 Morris RdCollege ParkGA 30,349 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365NNX 0 0 0 0 0 0 X 0 0 45 7 7 12.0 11 2,299 2,299 89.98%$204,842 $30,628 $235,470 14.95%$5,602 $32,456 $0 0.0%$0 $0 $2,430 $9,108 $0 $0 $13,803 $0 $25,341 54.47%$0 $9,041 $1,800 $1,682 3331$0.5050 $0 $0 $12,523 $0.00 $3,711.00 $4,192.00 $0.00 $7,903.00 $45,766.74 $0$0$0$32,000$0 $234,084 $0 $0 $0 $0$0$0
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CCIFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgPalmetto Group Home4173128410 Gullatt RoadPalmettoGA 30,268 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365NNX 0 0 0 0 0 0 X 0 0 45 6 6 12.0 8 1,655 1,752 75.57%$210,426 $30,932 $241,358 14.70%$5,997 $35,303 $0 0.0%$0 $0 $3,536 $10,107 $0 $0 $19,552 $0 $33,195 58.90%$0 $13,043 $1,750 $2,455 4861$0.5050 $0 $0 $17,248 $0.00 $4,040.00 $4,668.00 $0.00 $8,708.00 $59,151.25 $0$0$0$62,142$0 $168,512 $0 $0 $0 $0$0$0
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CCIFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgSecond Chance Home4173352625 Jerome RoadAtlantaGA 30,349 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365NN 0 X 0 0 0 0 X 0 0 45 9 9 12.0 13 2,132 2,628 64.90%$265,622 $31,657 $297,279 11.92%$7,793 $59,118 $0 0.0%$0 $0 $7,748 $25,452 $0 $0 $17,998 $0 $51,197 35.15%$0 $6,972 $3,550 $1,594 3156$0.5050 $0 $0 $12,116 $0.00 $6,495.00 $9,900.00 $0.00 $16,395.00 $79,708.24 $0$0$0$17,579$160,681 $0 $0 $0 $234,590 $0$0$0
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CCIFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgIndependent Living4173141105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365NN 0 0 X 0 0 0 X 0 0 9 9 12.0 6 1,584 2,628 48.22%$70,974 $9,961 $80,935 14.03%$2,450 $49,585 $0 0.0%$0 $0 $0 $1,619 $0 $0 $0 $0 $1,619 0.00%$0 $0 $0 $3,413 6755$0.5050 $0 $0 $3,413 $0.00 $1,622.00 $0.00 $0.00 $1,622.00 $6,653.90 $0$0$1,589$12,000$0 $0 $0 $0 $0 $0$134,624$0
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CPAFamilies First, Inc.1105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.orgFamily Foster Care4173151105 W Peachtree St, NEAtlantaGA 30,309 40485328134047592751pedwards@familiesfirst.org7/1/20106/30/2011365X 0 X 0 0 35 75 6 4 12 8 12.0 97 11,565 $282,135 $37,066 $319,201 13.14%$237,152 $96,034 $0 0.0%$0 $0 $0 $7,902 $0 $0 $0 $0 $7,902 0.00%$0 $0 $0 $13,365 26,465 $0.51 $0 $0 $13,365 $0 $7,854 $0 $0 $7,854 $29,121$0$0$19,188$39,500$156,350$297,420$38,449$1,401$32,876$0$0$0
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CCIFamily Support CouncilP.O.Box 1707DaltonGA 30,722 70627279197062756542hollyrice@windstream.netOak Haven Second Chance Home417382216 Fort Hill TerraceDaltonGA 30,721 70625945507062756542hollyrice@windstream.net1/1/201112/31/2011365NN 0 0 X 0 0 0 0 X 0 0 12 12 12 12.0 9 1,681 3,504 38.38%$237,684 $47,186 $284,870 19.85%$41,118 $51,302 $0 0.0%$7,230 $0 $903 $7,446 $0 $1,494 $14,596 $210 $31,879 45.79%$0 $5,258 $1,624 $2,952 7029$0.4200 $0 $0 $9,834 $0.00 $3,012.00 $0.00 $0.00 $3,012.00 $44,725.00 $0$0$0$32,658$217,874 $0 $0 $0 $171,483 $0$0$0
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CPAGeorgia Agape, Inc.3094 Mercer University DR, Suite 200AtlantaGeorgia 30341-414177045299951104573623Dana@GeorgiaAgape.orgGeorgia Agape, Inc.4169203094 Mercer University DR, Suite 200AtlantaGeorgia30341-414177045299957704573623Dana@GeorgiaAgape.org11/1/201010/31/2011365X 0 X 0 0 32 67 4 10 15 20 12.0 62 7,593 31.00%$328,560 $82,162 $410,722 25.01%$143,504 $96,580 $0 0.0%$0 $0 $1,707 $7,554 $849 $0 $1,455 $14,899 $26,465 5.50%$0 $1,219 $293 $18,473 36,946 $0.50 $0 $3,336 $23,322 $54 $7,492 $0 $5,771 $13,317 $63,104$0$0$17,533$739,862$76,811$221,948$26,621$0$0$0$0$0
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CPAGeorgia Parent Support Network, Inc.1381 Metropolitan Parkway SWAtlantaGeorgia 30310-445540475845004047586833noneTherapeutic Foster Care353781381 Metropolitan Parkway SWAtlantaGeorgia30310-445540475845006789044523vanessa.laney@gpsn.org1/1/201112/31/2011365x 0 x 0 0 26 72 13 6 42 14 12.0 106 12,108 46.00%$364,151 $63,244 $427,395 17.37%$573,336 $102,256 $0 0.0%$0 $30,000 $0 $22,976 $0 $0 $0 $0 $52,976 0.00%$0 $0 $0 $14,436 28,306 $0.51 $0 $0 $14,436 $0 $9,695 $0 $0 $9,695 $77,107$0$0$5,006$0$169$198,352$632,854$0$176,948$0$0$0
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CCIGoshen Valley Foundation, Inc.387 Goshen WayWaleskaGeorgia 30,183 770-796-4618770-796-1954tkuester@gmail.comGoshen Valley Boys Ranch35392387 Goshen Church WayWaleskaGeorgia 30,183 770-796-4618770-796-1954tkuester@gmail.com1/1/201112/31/2011365YNX 0 0 0 0 0 0 X 0 0 30 25 25 12.0 96 8,927 8,927 97.83%$524,108 $249,644 $773,752 47.63%$87,126 $389,448 $0 0.0%$167,007 $33,921 $14,908 $84,817 $0 $0 $57,601 $0 $358,254 16.08%$0 $104,073 $15,482 Requires entry into Cell H31 if claiming expense0$0 $0 $119,555 $0.00 $3,882.00 $0.00 $34,898.00 $38,780.00 $516,589.00 $0$0$0$604,954$0 $476,110 $548,294 $0 $0 $0$0$0
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CCIHephzibah Ministries, Inc. dba Hephzibah Children's Home6601 Zebulon RoadMaconGeorgia 31,220 47847733834784746370drivers@hephzibah.comHephzibah Ministries, Inc. dba Hephzibah Children's Home354146601 Zebulon RoadMaconGeorgia 31,220 47847733834784746370drivers@hephzibah.com7/1/20106/30/2011365YNX 0 0 0 0 0 0 X 0 0 80 40 28 12.0 42 5,561 8,176 38.09%$369,909 $88,125 $458,034 23.82%$26,133 $165,688 $0 0.0%$0 $0 $7,141 $85,560 $0 $0 $3,699 $4,324 $100,724 3.67%$0 $26,730 $9,944 $154 308$0.5000 $0 $0 $36,828 $0.00 $20,202.00 $0.00 $40,341.00 $60,543.00 $198,095.00 $474$0$2,316$277,260$0 $567,901 $0 $0 $0 $0$0$0
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CCIHephzibah Ministries, Inc. dba Hephzibah Children's Home6601 Zebulon RoadMaconGeorgia 31,220 47847733834784746370drivers@hephzibah.comTeen Parent Home833396601 Zebulon RoadMaconGeorgia 31,220 47847733834784746370drivers@hephzibah.com7/1/20106/30/2011365YN 0 0 X 0 0 0 0 X 0 0 80 10 10 12.0 16 2,405 2,920 65.89%$276,615 $60,717 $337,332 21.95%$14,106 $127,601 $0 0.0%$0 $0 $3,396 $56,638 $0 $0 $2,050 $2,385 $64,469 3.18%$0 $19,609 $7,164 $85 170$0.5000 $0 $0 $26,858 $0.00 $11,349.00 $0.00 $17,729.00 $29,078.00 $120,405.00 $894$0$394$178,864$521 $0 $0 $0 $408,232 $0$0$0
34
CPAHillside, Inc.690 Courtenay Drive NEAtlantaGA30306-342140487545514048751394rsouthworth@hside.orgHillside Family Foster Care35417690 Courtenay Drive NEAtlantaGA30306-342140487545514048751394rsouthworth@hside.org7/1/20106/30/2011365X 0 X 0 0 21 37 2 3 4 6 12.0 28 5,810 $263,928 $53,807 $317,735 20.39%$344,551 $69,906 $0 0.0%$0 $0 $0 $12,000 $0 $0 $0 $0 $12,000 0.00%$0 $12,185 $4,566 $9,105 20,693 $0.44 $0 $0 $25,856 $0 $0 $0 $0 $0 $37,856$0$0$0$53,128$0$10,335$217,214$0$402,476$0$0$0
35
CPALighthouse Foster Care, Inc.35 Mountain Street RinggoldGeorigia 30,736 70693742367069374235lighthousetfc@catt.comLighthouse Foster Care, Inc3544635 Mountain StreetRinggoldGA 30,736 70693742367069374235lighthousetfc@catt.com7/1/20106/30/2011365x 0 x 0 0 3 6 3 4 6 8 12.0 49 5,293 $123,744 $13,068 $136,812 10.56%$107,719 $28,620 $0 0.0%$0 $6,140 $0 $2,400 $0 $0 $0 $0 $8,540 0.00%$0 $0 $0 $15,673 31,544 $0.50 $0 $0 $15,673 $0 $0 $0 $0 $0 $24,213$0$0$16,201$0$0$0$250,644$0$0$0$0$20,114
36
CPALOOKOUT MOUNTAIN COMMUNITY SERVICES501 MIZE STREETLaFAYETTEGEORGIA 30,728 706-638-5584706-638-5445tomf@lmcs.orgTREK4172881875 FANT DRIVEFORT OGLETHROPEGEORGIA 30,742 706-638-5584706-638-5445johnb@lmcs.org7/1/20106/30/2011365X 0 0 0 X 45 112 10 8 20 18 12.0 182 28,099 69.00%$513,841 $199,636 $713,477 38.85%$1,104,585 $114,820 $0 0.0%$0 $4,482 $972 $4,295 $0 $0 $904 $0 $10,653 8.49%$7,559 $14,216 $0 $1,514 3,003 $0.50 $0 $0 $23,289 $0 $3,535 $9,940 $0 $13,475 $47,417$0$0$64,809$0$30,686$700,930$1,325,314$0$0$0$0$0
37
CPALutheran Services of Georgia, Inc.1330 West Peachtree StreetAtlantaGeorgia30309-2943404-875-0201404-875-9258www.lsga.orgAlbany Special Needs Foster Care4169351120 West Broad Avenue, Suite B-2AlbanyGeorgia 31,707 22943276642294327913tkiegler@lsga.org10/1/20109/30/2011365X 0 X 0 0 8 21 3 3 9 7 12.0 15 2,377 31.00%$72,240 $9,983 $82,223 13.82%$79,025 $13,992 $20,846 9.6%$0 $8,328 $0 $2,905 $0 $0 $122 $0 $11,356 1.08%$0 $0 $0 $5,727 13,016 $0.44 $0 $0 $5,727 $0 $4,808 $0 $206 $5,014 $22,097$0$0$785$401$34,523$997$1,982$0$101,554$978$0$35,557
38
CPALutheran Services of Georgia, Inc.1330 West Peachtree StreetAtlantaGeorgia30309-2943404-875-0201404-875-9258lsga.orgAtlanta Special Needs Foster Care4174911330 West Peachtree Street, Suite 300AtlantaGeorgia30309-294340487502014048759258tbrand@lsga.org10/1/20109/30/2011365X 0 X 0 0 50 140 18 13 47 36 12.0 121 18,853 37.00%$414,006 $70,852 $484,858 17.11%$954,392 $51,468 $184,723 10.6%$0 $39,557 $0 $0 $0 $0 $105 $0 $39,661 0.26%$0 $0 $0 $20,415 46,398 $0.44 $0 $0 $20,415 $0 $7,260 $0 $1,586 $8,846 $68,923$0$0$25,699$1,265$107,412$239,503$386,247$62,005$409,588$614,737$0$0
39
CPALutheran Services of Georgia, Inc.1330 West Peachtree StreetAtlantaGeorgia30309-2943404-875-0201404-875-9258lsga.orgRome Special Needs Foster Care62039101-C Elliott Drive NWRomeGeorgia 30,165 70623216967062325610tball@lsga.org10/1/20109/30/2011365X 0 X 0 0 13 37 5 1 15 2 12.0 46 7,618 56.00%$143,268 $26,617 $169,886 18.58%$325,067 $23,427 $63,632 10.6%$0 $5,077 $0 $803 $0 $0 $6 $0 $5,886 0.11%$0 $0 $0 $9,403 21,371 $0.44 $0 $0 $9,403 $0 $4,062 $0 $601 $4,663 $19,953$0$0$13,678$250$16,884$189,652$244,011$0$8,763$125,687$0$0
40
CPALutheran Services of Georgia, Inc.1330 West Peachtree StreetAtlantaGeorgia30309-2943404-875-0201404-875-9258lsga.orgSavannah Special Needs Foster Care4174206555 Abercorn Street, Suite 200SavannahGeorgia 31,405 91235388759123565057kmckenzie@lsga.org10/1/20109/30/2011365X 0 X 0 0 27 65 2 6 5 16 12.0 71 12,637 53.00%$244,857 $38,466 $283,322 15.71%$492,517 $41,707 $105,158 10.6%$0 $57,790 $0 $0 $0 $0 $462 $0 $58,252 0.79%$0 $0 $0 $8,679 19,725 $0.44 $0 $0 $8,679 $0 $5,786 $0 $1,313 $7,099 $74,030$0$0$12,802$5,075$160,130$64,368$422,898$32,850$118,862$162,120$0$0
41
CPAMeritan, Inc.4700 Poplar Avenue, Suite 400MemphisTN 38,117 901-766-0600901-766-0614georgerutherford@meritan.orgGeorgia Stepping Stones (Cartersville Office)417426920 A North Tennessee StreetCartersvilleGA 30,120 770-387-9003770-387-2409joemiracle@meritan.org7/1/20106/30/2011365x 0 x 0 0 47 116 11 7 22 18 12.0 111 21,113 50.00%$363,612 $123,250 $486,862 33.90%$1,122,570 $75,198 $0 0.0%$0 $43,006 $0 $7,429 $79 $180 $529 $0 $51,223 1.03%$0 $0 $0 $33,215 72,207 $0.46 $0 $0 $33,215 $0 $5,758 $0 $6,856 $12,614 $97,052$0$0$0$0$0$465,285$1,112,798$34,832$45,260$0$0$0
42
CPAMeritan, Inc.4700 Poplar Avenue, Suite 400MemphisTN 38,117 901-766-0600901-766-0614georgerutherford@meritan.orgGeorgia Stepping Stones (Macon Office)417414300 Northside CrossingMaconGA 31,210 478-474-8552478-474-8915joemiracle@meritan.org7/1/20106/30/2011365x 0 x 0 0 52 137 12 17 36 51 12.0 121 24,923 50.00%$361,261 $108,278 $469,539 29.97%$1,330,105 $89,334 $0 0.0%$0 $45,296 $0 $4,313 $211 $533 $508 $0 $50,861 1.00%$0 $0 $0 $50,374 109,509 $0.46 $0 $0 $50,374 $0 $4,253 $0 $5,945 $10,198 $111,433$0$0$0$0$13,311$679,114$900,830$31,230$367,678$74,328$0$0
43
CPAMURPHY-HARPST CHILDRENS CENTERS, INC.740 FLETCHER STREETCEDARTOWNGEORGIA 30,125 77074815007707491094contact@murphyharpst.orgMURPHY-HARPST SPECIALIZED FOSTER CARE RBWO417421130 GRADY ROADROCKMARTGEORGIA 30,153 77074806867707495049contact@murphyharpst.org7/1/20106/30/2011365x 0 x 0 0 23 34 7 2 7 2 12.0 43 8,704 $283,719 $47,408 $331,127 16.71%$460,963 $31,506 $0 0.0%$0 $0 $0 $9,841 $0 $0 $2,105 $3,181 $15,127 13.92%$0 $110 $0 $14,478 36,195 $0.40 $0 $7,009 $21,597 $0 $662 $0 $8,049 $8,711 $45,435$0$0$4,179$0$0$1,639$416,976$0$501,614$0$0$0
44
CCIMURPHY-HARPST CHILDREN'S CENTERS, INC.740 FLETCHER STREETCEDARTOWNGEORGIA 30,125 77074815007707491094contact@murphyharpst.orgHARPST CAMPUS RBWO417489740 FLETCHER STREETCEDARTOWNGEORGIA 30,125 77074815007707491094contact@murphyharpst.org7/1/20106/30/2011365NNX 0 0 0 0 0 0 X 0 0 56 56 56 12.0 95 19,244 19,244 94.15%$2,597,474 $434,459 $3,031,933 16.73%$49,051 $324,875 $0 0.0%$0 $0 $0 $119,273 $0 $0 $30,526 $17,802 $167,601 18.21%$0 $26,448 $0 $1,268 3169$0.4000 $0 $24,129 $51,845 $0.00 $6,347.00 $0.00 $32,287.00 $38,634.00 $258,080.00 $75,098$0$2,712$5,505$0 $0 $0 $3,498,425 $0 $0$0$0
45
CPANational Mentor Healthcare, LLC DBA Georgia MENTOR18 Executive Park Drive, Ste 1823AtlantaGA 30,029 40494661424049466196Shirley.Woods@TheMentorNetwork.comNational Mentor Healthcare, LLC DBA Georiga MENTOR - Albany354982200 Watergate Court AlbanyGA 31,707 22943566012294359715Shirley.WoodsQTheMentorNetwork.com10/1/20109/30/2011365X 0 0 X 0 22 22 5 2 5 2 12.0 64 8,683 108.00%$154,523 $31,423 $185,946 20.34%$325,411 $84,958 $39,226 5.6%$0 $26,524 $116 $3,709 $46 $0 $3,381 $531 $34,307 9.86%$0 $137 $0 $11,184 27,960 $0.40 $262 $3,553 $15,136 $0 $482 $0 $11,107 $11,589 $61,032$0$0$5,347$0$15,048$179,284$387,739$2,619$62,124$0$0$0
46
CPANational Mentor Healthcare, LLC DBA Georgia MENTOR18 Executive Park Drive, Ste 1823AtlantaGA 30,029 40494661424049466196Shirley.Woods@TheMentorNetwork.comNational Mentor Healthcare, LLC DBA Georiga MENTOR - Athens35497220 Ben Burton Circle Ste ABogartGA 30,622 70642518147064251986Shirley.WoodsQTheMentorNetwork.com10/1/20109/30/2011365X 0 0 X 0 24 24 12 4 12 4 12.0 52 6,013 69.00%$128,850 $26,517 $155,367 20.58%$282,514 $67,496 $32,806 5.7%$0 $20,710 $95 $2,714 $134 $0 $2,618 $211 $26,482 9.89%$0 $111 $0 $7,580 18,860 $0.40 $126 $1,315 $9,132 $0 $180 $0 $5,888 $6,068 $41,682$0$0$3,332$0$2,155$55,935$292,090$111,513$7,306$78,050$0$0
47
CPANational Mentor Healthcare, LLC DBA Georgia MENTOR18 Executive Park Drive, Ste 1823AtlantaGA 30,029 40494661424049466196Shirley.Woods@TheMentorNetwork.comNational Mentor Healthcare, LLC DBA Georiga MENTOR - Atlanta3549318 Executive Park Drive, Ste 1823AtlantaGA 30,029 40472815674049829877Shirley.WoodsQTheMentorNetwork.com10/1/20109/30/2011365X 0 0 X 0 52 52 20 18 20 18 12.0 81 18,003 95.00%$430,890 $83,118 $514,008 19.29%$747,461 $182,107 $94,657 5.7%$0 $70,774 $292 $123 $665 $0 $2,429 $4,293 $78,576 3.09%$0 $343 $0 $27,944 69,861 $0.40 $333 $3,096 $31,716 $0 $5,565 $0 $22,026 $27,591 $137,883$0$0$8,619$0$23,318$353,614$414,538$172,175$417,073$96,318$0$6,000
48
CPANational Mentor Healthcare, LLC DBA Georgia MENTOR18 Executive Park Drive, Ste 1823AtlantaGA 30,029 40494661424049466196Shirley.Woods@TheMentorNetwork.comNational Mentor Healthcare, LLC DBA Georiga MENTOR - Augusta354954210 Columbia Rd Ste 17AMartinezGA 30,907 70686852687068685865Shirley.WoodsQTheMentorNetwork.com10/1/20109/30/2011365X 0 0 X 0 29 29 10 9 10 9 12.0 55 10,632 100.00%$165,547 $25,946 $191,494 15.67%$452,284 $106,369 $48,617 5.7%$0 $26,962 $151 $3,782 $146 $0 $3,802 $222 $35,065 10.84%$0 $177 $0 $8,900 22,250 $0.40 $425 $4,949 $14,451 $0 $2,284 $0 $7,465 $9,749 $59,265$0$0$4,103$0$76$218,201$389,401$32,850$153,636$96,007$0$0
49
CPANational Mentor Healthcare, LLC DBA Georgia MENTOR18 Executive Park Drive, Ste 1823AtlantaGA 30,029 40494661424049466196Shirley.Woods@TheMentorNetwork.comNational Mentor Healthcare, LLC DBA Georiga MENTOR - Macon354964977 Mt Pleasant Church RoadMaconGA 31,216 47878500054787850006Shirley.WoodsQTheMentorNetwork.com10/1/20109/30/2011365X 0 0 X 0 34 34 11 9 11 9 12.0 99 14,858 120.00%$310,933 $56,374 $367,308 18.13%$699,629 $158,733 $79,559 5.7%$0 $56,653 $247 $4,073 $98 $0 $9,129 $640 $70,840 12.89%$0 $290 $0 $14,888 37,221 $0.40 $550 $1,557 $17,285 $0 $1,425 $0 $8,881 $10,306 $98,431$0$0$6,253$0$0$167,000$661,382$34,675$263,804$232,477$0$0
50
CPANational Mentor Healthcare, LLC DBA Georgia MENTOR18 Executive Park Drive, Ste 1823AtlantaGA 30,029 40494661424049466196Shirley.Woods@TheMentorNetwork.comNational Mentor Healthcare, LLC DBA Georiga MENTOR - Savannah354947130 Hodgson Memorial Drive Ste 203SavannahGA 31,406 91235489909123540031Shirley.WoodsQTheMentorNetwork.com10/1/20109/30/2011365X 0 0 X 0 16 16 3 6 3 6 12.0 55 7,557 129.00%$179,963 $36,511 $216,474 20.29%$278,866 $92,435 $39,946 5.6%$0 $47,768 $117 $69 $207 $0 $1,948 $613 $50,722 3.84%$0 $137 $0 $16,776 41,940 $0.40 $144 $3,300 $20,357 $0 $1,007 $0 $8,094 $9,101 $80,180$0$0$5,773$0$44,093$112,606$201,678$3,600$153,800$71,934$0$0
51
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgNeighbor to Family - Augusta35506801 Greene StreetAugustaGA 30,901 706-396-2180706-396-2199neighbortofamily.org7/1/20106/30/2011365X 0 X 0 0 8 32 1 5 3 17 12.0 61 11,233 96.00%$386,474 $73,862 $460,336 19.11%$109,258 $56,922 $94,662 12.6%$0 $8,730 $0 $2,828 $0 $0 $1,512 $0 $13,070 11.57%$0 $0 $0 $7,050 13,960 $0.51 $0 $2,570 $9,621 $0 $6,544 $0 $0 $6,544 $29,234$0$0$4,596$1,010$0$0$0$0$0$0$584,704$0
52
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgNeighbor to Family - Chatham35506801 Greene StreetAugustaGA 30,901 706-396-2180706-396-2199neighbortofamily.org0701/20106/30/2011365x 0 x 0 0 6 18 3 2 13 8 17 4,761 $95,822 $17,800 $113,622 18.58%$74,279 $11,008 $31,328 12.6%$0 $0 $0 $0 $0 $0 $18 $0 $18 100.00%$0 $0 $0 $349 691 $0.51 $0 $17,960 $18,309 $0 $390 $0 $0 $390 $18,717$0$0$3,120$272$0$0$0$0$0$0$426,108$0
53
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgNeighbor to Family - Clayton County355013000 CORPORATE CENTER DRIVE AT 340MORROWGA 30,260 67842297706784229812neighbortofamily.org7/1/20106/30/2011365x 0 x 0 0 10 34 7 6 23 23 12.0 33 6,234 50.00%$201,740 $48,989 $250,729 24.28%$99,856 $33,424 $71,130 12.7%$0 $96,700 $0 $0 $0 $0 $41 $0 $96,741 0.04%$0 $0 $0 $4,836 9,576 $0.51 $524 $177 $5,537 $0 $2,043 $0 $3,013 $5,056 $107,334$0$0$1,685$1,271$0$0$0$0$0$0$557,943$0
54
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgDekalb County355031900 Century PlAtlantaGA 30,345 404-315-0100404-486-5844neighbortofamily.org7/1/20106/30/2011365x 0 x 0 0 28 99 10 9 42 34 12.0 170 24,599 68.00%$1,002,033 $185,372 $1,187,406 18.50%$401,902 $105,696 $267,573 12.6%$0 $124,388 $0 $0 $0 $0 $156 $0 $124,544 0.13%$0 $0 $0 $28,978 57,382 $0.51 $1,886 $2,700 $33,564 $0 $6,690 $0 $0 $6,690 $164,798$0$0$21,864$5,107$0$0$0$0$0$0$2,201,629$0
55
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgNeighbor to Family - Douglas County355022075 West Park Place Blvd, Ste DStone MountainGA 30,087 770-465-5170770-465-5172neighbortofamily.org7/1/20106/30/2011365x 0 x 0 0 16 54 9 8 40 24 12.0 88 7,820 40.00%$409,945 $68,643 $478,589 16.74%$130,178 $35,086 $105,921 12.6%$0 $59,413 $0 $7,365 $0 $0 $4,382 $0 $71,160 6.16%$0 $0 $0 $16,396 31,196 $0.53 $746 $1,053 $18,195 $0 $1,318 $0 $0 $1,318 $90,673$0$0$6,038$2,040$0$0$0$0$0$0$699,890$0
56
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgFulton County355051900 Century Place, Ste 310AtlantaGA 30,345 404-315-0100404-315-8881neighbortofamily.org7/1/20106/30/2011365x 0 x 0 0 40 96 0 30 5 50 12.0 203 35,105 100.00%$1,527,438 $229,841 $1,757,279 15.05%$590,252 $149,529 $386,386 12.5%$0 $117,812 $0 $0 $0 $0 $226 $0 $118,038 0.19%$0 $0 $0 $43,588 86,313 $0.51 $0 $7,202 $50,790 $0 $13,181 $0 $17,705 $30,886 $199,714$0$0$20,850$8,683$0$0$0$0$0$0$3,141,919$0
57
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgNeighbor to Family - Gwinett County355042075 WEST PARK PLACE BLVD, STE DSTONE MOUNTAINGA 30,087 77046551707704655172neighbortofamily.org7/1/20106/30/2011365x 0 x 0 0 9 28 11 6 37 20 12.0 47 6,996 68.00%$258,949 $36,243 $295,192 14.00%$113,473 $38,545 $69,071 12.6%$0 $0 $0 $0 $0 $0 $44 $0 $44 100.00%$0 $0 $0 $19,013 37,650 $0.51 $484 $683 $20,181 $0 $6,140 $0 $4,036 $10,176 $30,400$0$0$4,266$1,081$0$0$0$0$0$0$626,142$0
58
CPANeighbor to Family220 S Ridgewood Ave Ste 260Daytona BeachFlorida 32,808 386-523-1440386-523-1459neighbortofamily.orgNeighbor to Family - Henry County620381526 E. Forrest AvenueEast PointGeorgia 30,344 678-553-6240678-553-6257neighbortofamily.org7/1/20106/30/2011365X 0 X 0 0 1 3 1 0 3 0 12.0 11 1,188 108.00%$15,965 $3,745 $19,710 23.46%$19,481 $575 $5,734 12.6%$0 $0 $0 $0 $0 $0 $3 $0 $3 100.00%$0 $0 $0 $34 67 $0.51 $39 $55 $129 $0 $69 $0 $0 $69 $201$0$0$0$82$0$0$0$0$0$0$106,326$0
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CPAOmni Visions, Inc.301 S. Perimeter Park Drive, Ste 210NashvilleTN 37,211 61572636036157263632memerson@omnivisions.comOmni Visions, Inc.42700-040-00000091302200 Northlake Parkway, Suite 320TuckerGA 30,084 6784358126786465545kwoods@omnivisions.com1/1/201112/31/2011365x 0 0 x 0 25 62 25 7 62 16 12.0 74 11,339 50.00%$242,635 $48,656 $291,291 20.05%$399,486 $110,713 $47,165 5.1%$0 $25,283 $190 $3,029 $0 $0 $4,279 $0 $32,781 13.05%$0 $0 $0 $20,777 55,264 $0.38 $13,991 $0 $34,768 $0 $8,105 $0 $0 $8,105 $75,654$0$0$30,487$0$0$291,765$397,936$1,800$3,844$45,384$0$0
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CCIOpen Arms Children's Network, Inc.1841 Nottingham RoadStatesboroGeorgia 30,461 912-690-3242912-489-1249kimberlyrobinson78@yahoo.comOrdered Steps Home for Girls80481896 Bryant Still RoadBrookletGeorgia 30,415 912-823-2016912-489-1249kimberlyrobinson78@yahoo.com1/1/201112/31/2011365 0 0 x 0 0 0 0 0 0 x 0 0 6 6 6 12.0 8 1,885 1,885 86.07%$138,556 $11,918 $150,474 8.60%$5,400 $22,998 $0 0.0%$5,131 $0 $1,344 $2,837 $603 $0 $330 $0 $10,245 3.22%$0 $4,018 $0 $2,266 4255$0.5330 $0 $0 $6,284 $472.00 $0.00 $0.00 $2,310.00 $2,782.00 $19,311.00 $0$0$0$0$0 $140,512 $65,135 $0 $0 $0$0$0
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CCIOpen Door Home5 Leon StreetRomeGA 30,165 70623266627062356230gwilson@opendoorhome.orgBoys Annex Long Term Program35532792 John Davenport DriveRomeGA 30,165 70623391757062339211jane@wjrcpas.com1/1/201112/31/2011365YNX 0 0 0 0 0 0 X 0 0 40 20 20 12.0 36 4,706 5,840 64.47%$407,107 $90,157 $497,264 22.15%$15,911 $72,924 $0 0.0%$0 $0 $5,081 $29,135 $0 $1,083 $7,632 $0 $42,931 17.78%$0 $8,347 $4,616 Requires entry into Cell H31 if claiming expense0$0 $0 $12,963 $0.00 $1,414.00 $0.00 $14,105.50 $15,519.50 $71,413.50 $14,671$0$7,668$172,532$82,606 $410,760 $0 $0 $0 $0$0$0
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CCIOpen Door Home5 Leon StreetRomeGA 30,165 70623266627062356230gwilson@opendoorhome.orgGirls Annex Long Term Program355315 Leon StreetRomeGA 30,165 70623266627062356230jane@wjrcpas.com1/1/201112/31/2011365YNX 0 0 0 0 0 0 X 0 0 40 20 20 12.0 46 4,102 5,840 56.19%$423,918 $92,161 $516,080 21.74%$16,972 $71,721 $0 0.0%$0 $0 $5,081 $33,565 $0 $1,688 $13,018 $0 $53,352 24.40%$0 $10,393 $4,616 Requires entry into Cell H31 if claiming expense0$0 $0 $15,009 $0.00 $5,289.00 $0.00 $14,106.00 $19,395.00 $87,756.00 $14,671$0$4,965$201,308$107,293 $367,515 $0 $0 $0 $0$0$0
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CCIPark Place Outreach, Inc.514 East Henry StreetSavannahGA 31,401 91223440489126513621Hiltssrh@aol.comPark Place Outreach, Inc.35537514 East Henry StreetSavannahGA 31,401 91223440489126513621Hiltssrh@aol.com1/1/201112/31/2011365YN 0 0 0 0 0 0 XX 0 0 0 12 12 12.0 97 1,790 3,504 40.87%$278,957 $48,346 $327,303 17.33%$34,160 $29,826 $0 0.0%$0 $0 $8,759 $9,694 $0 $1,039 $4,372 $0 $23,864 18.32%$0 $5,359 $1,539 $1,549 3038$0.5100 $0 $0 $8,447 $0.00 $5,132.00 $0.00 $11,603.00 $16,735.00 $49,046.45 $5,465$204,072$1,121$159,658$22,113 $51,434 $0 $0 $0 $0$0$0
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CCIRESCARE, INC. dba ALTERNATIVE YOUTH SERVICES, INC.9901 LINN STATION ROADLOUISVILLEKENTUCKY40223-380850239422755024202548smcgrath@rescare.comGEORGIA CENTER - ALTERNATIVE YOUTH SERVICES#417700211 GOOSE HOLLOW ROADREYNOLDSGEORGIA 31,076 47884729004788472899nmcpherson@rescare.com1/1/201112/31/2011365nnx 0 0 0 0 0 0 x 0 0 0 60 60 12.0 95 10,104 17,520 46.14%$1,030,440 $191,401 $1,221,841 18.57%$46,907 $236,507 $113,411 6.2%$0 $0 $4,017 $90,805 $15,733 $0 $37,318 $0 $147,873 25.24%$0 $25,900 $14,941 $1,468 3670$0.4000 $0 $0 $42,309 $0.00 $4,211.00 $58.00 $20,258.00 $24,527.00 $214,709.00 $0$0$0$0$66,372 $0 $0 $1,770,940 $0 $0$0$0
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CCISouth Georgia Community Service Board d/b/a Behavioral Health Services of S. GA3120 N. Oak Street Ext., Suite CValdostaGA 31,602 22967161402296716740sjackson@bhsga.comLowndes C & A Group Home (Northpoint)352434401 Willow Wood GateValdostaGA 31,602 22924747342292422984sjackson@bhsga.com7/1/20106/30/2011365 0 0 X 0 0 0 0 0 0 0 0 X 12 6 6 12.0 10 2,121 2,121 96.85%$178,360 $60,284 $238,644 33.80%$0 $57,073 $0 0.0%$0 $18,000 $0 $7,653 $0 $0 $3,195 $0 $28,848 11.08%$0 $7,388 $0 $688 0.405$1,698.5430 $0 $0 $8,076 $0.00 $1,788.00 $2,375.36 $0.00 $4,163.36 $41,087.95 $0$0$0$854$3,180 $70,320 $187,490 $20,912 $0 $0$0$0
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CCIStar Island, Inc218 S. MacArthur DriveCamillaGA 31,730 22933617002293361702szellner@sbzservices.comStar Island, Inc11302227218 S. MacArthur DriveCamillaGA 31,730 22933617002293361702szellner@sbzzervices.com9/12/201112/31/2011111NNX 0 0 0 0 0 0 x 0 0 10 10 10 4.0 9 114 888 3.12%$33,357 $3,369 $36,726 10.10%$18,906 $20,091 $0 0.0%$1,235 $0 $795 $2,567 $0 $0 $9,785 $14,382 68.04%$441 $1,562 $1,220 Requires entry into Cell H31 if claiming expense0$124 $0 $3,347 $534.00 $890.00 $0.00 $425.00 $1,849.00 $19,578.00 $1,419$0$555$51,000$0 $40,387 $0 $0 $0 $0$0$0
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CCIVashti Center1815 E. Clay StreetThomasvilleGeorgia 31,792 22922646342292251093carolm@vashti.orgVashti Center CCI Placements356291815 E. Clay StreetThomasvilleGeorgia 31,792 22922646342292251093carolm@vashti.org7/1/20106/30/2011365NNX 0 0 0 0 0 0 X 0 0 42 42 42 12.0 81 11,728 12,264 76.50%$1,227,751 $316,714 $1,544,465 25.80%$44,339 $250,457 $0 0.0%$764 $660 $248 $81,215 $0 $2,218 $57,307 $0 $142,412 40.24%$0 $22,317 $10,021 $511 1022$0.5000 $262 $10,362 $43,473 $0.00 $4,784.00 $0.00 $0.00 $4,784.00 $190,669.00 $0$0$0$0$0 $83,798 $606,335 $1,101,950 $0 $0$0$0
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CCIThe Young Adult Guidance Center, Inc.1230 Hightower Rd, NWAtlantaGeorgia 30,318 40479276164047940151tarlamar@aol.comThe Young Adult Guidance Center, Inc.355971230 Hightower Rd, NWAtlantaGeorgia 30,318 40479276164047940151tarlamar@aol.com1/1/201112/31/2011365 0 0 x 0 0 0 0 0 0 x 0 0 12 12 12 12.0 34 2,996 3,504 68.40%$431,944 $82,770 $514,714 19.16%$185,690 $185,801 $0 0.0%$46,767 $0 $0 $54,511 $0 $0 $41,152 $0 $142,430 28.89%$0 $30,880 $0 Requires entry into Cell H31 if claiming expense0$0 $0 $30,880 $0.00 $16,058.00 $0.00 $0.00 $16,058.00 $189,368.00 $20,133$700,787$0$19,757$35,523 $172,687 $0 $0 $0 $0$0$0
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All Data Summary