2025-10-24T15:01:06-05:00 2025-03-31 410746749 CLIFTONLARSONALLEN LLP 2021 SPRING ROAD SUITE 200 OAK BROOK IL 60523 990 2024-04-01 391181480 LA CLINICA DE LOS CAMPESINOS INC LACL 9207875514 400 S TOWNLINE RD WAUTOMA WI 54982 LAURA WALDVOGEL PRESIDENT AND CEO 9207875514 2025-10-24 1 0 CHRIS MANDERFIELD P01238973 6305738600 2025-10-24 2024 2025-03-06 01:10:19Z NOBLE COMMUNITY CLINICS LAURA WALDVOGEL 400 S TOWNLINE RD WAUTOMA WI 54982 26920453 0 X HTTPS://NOBLECLINICS.ORG X 1973 WI TO ENSURE ACCESS TO HIGH QUALITY INTEGRATED HEALTHCARE AND PROMOTE THE WELL-BEING OF OUR PATIENTS, STAFF, AND COMMUNITIES. 10 10 249 14 0 0 6325602 10885978 15642311 15774610 -549431 171525 0 0 21418482 26832113 10000 22000 0 0 16061562 17890973 0 0 0 8263065 6701852 24334627 24614825 -2916145 2217288 21244485 28274870 5944352 10728516 15300133 17546354 TO ENSURE ACCESS TO HIGH QUALITY INTEGRATED HEALTHCARE AND PROMOTE THE WELL-BEING OF OUR PATIENTS, STAFF, AND COMMUNITIES. 0 0 18456342 22000 15774610 FEDERALLY QUALIFIED HEALTH CENTER THAT PROVIDES PRIMARY MEDICAL, BEHAVIORAL HEALTH, DENTAL AND PHARMACY SERVICES TO OUR COMMUNITY, WITH LOCATIONS IN BEAVER DAM, FRIENDSHIP, MAUSTON, STEVENS POINT AND WAUTOMA WISCONSIN. 316054 THE WIC (WOMEN, INFANT, AND CHILDREN GRANT ALLOWS NOBLE TO PROVIDE SUPPLEMENTAL NUTRITION AND EDUCATION TO CLIENTS IN THE PROGRAM SERVICE AREA 18772396 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 43 0 249 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X CALEB JENSEMA 9207875514 400 S TOWNLINE RD WAUTOMA WI 54982 LORA BLASIUS CHAIRPERSON 1.00 X X 0 0 0 JUANITA OLIVAS VICE CHAIRPERSON 1.00 X X 0 0 0 SHEILA SHAW TREASURER 1.00 X X 0 0 0 HEIDI DELGADILLO-PICAZO SECRETARY 1.00 X X 0 0 0 FRED JOHANNES DIRECTOR 1.00 X 0 0 0 DAMARIS THOME DIRECTOR 1.00 X 0 0 0 ROMAN MULLEN DIRECTOR 1.00 X 0 0 0 LINDA SHELLEY DIRECTOR 1.00 X 0 0 0 ALMA TORRES DIRECTOR 1.00 X 0 0 0 PAUL THEYEL DIRECTOR 1.00 X 0 0 0 LAURA WALDVOGEL PRESIDENT AND CEO 40.00 X 237017 0 71081 IVAN COZIAHR CHIEF OPERATING OFFICER 40.00 X 186915 0 53954 THOMAS KAMINSKI CFO UNTIL 10/9/2024 40.00 X 221112 0 59177 JAVIER RINCON PHYSICIAN 30.00 X 228068 0 23542 SAMANTHA SEILER PHYSICIAN 40.00 X 225032 0 55681 KEVIN THAO CHIEF MEDICAL OFFICER 28.00 X 217668 0 60509 SAVITA BIMARTHI DENTIST 40.00 X 210566 0 54397 TIFFANY OTTO DENTIST/ASSOC. DENTAL DIRECTOR 40.00 X 209481 0 16948 1735859 0 395289 23 0 1 0 UTSCHIG INC N 1040 CRAFTSMENT DRIVE GREENVILLE WI 54942 CONSTRUCTION 4833186 SOMERVILLE INC 2100 RIVERSIDE DRIVE GREEN BAY WI 54301 ARCHITECTS 415868 D & S DENTAL LABORATORY PO BOX 234 WAUNAKEE WI 53597 DENTAL LAB SERVICES 405959 OCHIN INC PO BOX 5426 PORTLAND OR 97228 SOFTWARE AND CONSULTING 355518 THEILS BRAND DESIGN 320 E BUFFALO ST STE 5015 MILWAUKEE WI 53202 MARKETING 303386 10 9104267 1781711 10885978 PATIENT SERVICE REVENUE 621110 15774610 15774610 15774610 259865 259865 88340 -88340 -88340 -88340 26832113 15774610 0 171525 22000 22000 13795494 11548989 2246505 441922 412088 29834 2588901 2128124 460777 1064656 861243 203413 42259 15 42244 56804 56804 1641157 828855 812302 256127 74761 181366 756974 170170 586804 599791 462357 137434 161546 114450 47096 209023 209023 654035 336111 317924 187599 63414 124185 SUPPLIES 1626808 1588455 38353 REPAIRS & MAINTENACE 154215 119793 34422 BANK AND OTHER FEES 104261 96 104165 TRAINING 98707 10566 88141 152546 30909 121637 24614825 18772396 5842429 0 3683761 6606662 278508 103687 109209 478666 1133399 1273274 93611 46944 56693 63560 231455 181122 26507263 7429152 9947866 19078111 5213309 3944 496674 438900 21244485 28274870 1857468 2738331 395294 749912 3450889 7084737 240701 155536 5944352 10728516 X 14922389 16751864 377744 794490 15300133 17546354 21244485 28274870 X 2217288 28933 X X 0 1 X 1 1 1 X 9764525 8186618 7019299 6325602 10885978 42182022 9764525 8186618 7019299 6325602 10885978 42182022 42182022 1326 1207 93997 364650 259865 721045 42903067 76795355 0.98320 X PART I, LINE 3 LA CLINICA DE LOS CAMPESINOS IS A NOT-FOR-PROFIT CORPORATION THAT PROVIDES HEALTHCARE SERVICES THROUGH MEDICAL, BEHAVIORAL AND DENTAL CLINICS. IT IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL AND THEREFORE US NOT REQUIRED TO COMPLETE SCHEDULE H. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 772920 772920 9188462 2568204 6620258 463534 55541 407993 4146399 3607439 538960 11935948 1197968 10737980 19078111 LEASE LIABILITY, CURRENT 93772 LEASE LIABILITY, LONG TERM 61764 155536 X 26861046 0 26861046 -28933 -28933 26832113 24614825 0 24614825 0 24614825 PART X, LINE 2: THE ORGANIZATION IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND NOT A PRIVATE FOUNDATION AS DESCRIBED IN SECTION 509(A) FOR FEDERAL PURPOSES. THE ORGANIZATION IS ALSO TAX-EXEMPT UNDER WISCONSIN STATUTES FOR STATE PURPOSES. CONSEQUENTLY, THE ORGANIZATION RECORDS NO PROVISION FOR INCOME TAXES. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN COMMUNITY FUND 1 SCHOLARSHIP 1 22000 CASH PART 1 LINE 2 THE SCHOLARSHIPS AWARDED ARE MANAGED BY AN OUTSIDE FOUNDATION. THE FOUNDATION MAINTAINS THE RECORDS AND ENSURES THE RECIPIENTS MEET THE ELIGIBILITY REQUIREMENTS. X X 0 0 0 0 0 0 0 0 0 LAURA WALDVOGEL PRESIDENT AND CEO 237017 0 0 0 0 0 12708 0 58373 0 308098 0 0 0 SAMANTHA SEILER PHYSICIAN 208364 0 16668 0 0 0 9783 0 45898 0 280713 0 0 0 THOMAS KAMINSKI CFO UNTIL 10/9/2024 221112 0 0 0 0 0 11453 0 47724 0 280289 0 0 0 KEVIN THAO CHIEF MEDICAL OFFICER 187668 0 30000 0 0 0 8080 0 52429 0 278177 0 0 0 SAVITA BIMARTHI DENTIST 210566 0 0 0 0 0 10844 0 43553 0 264963 0 0 0 JAVIER RINCON PHYSICIAN 228068 0 0 0 0 0 0 0 23542 0 251610 0 0 0 IVAN COZIAHR CHIEF OPERATING OFFICER 186915 0 0 0 0 0 9610 0 44344 0 240869 0 0 0 TIFFANY OTTO DENTIST/ASSOC. DENTAL DIRECTOR 209481 0 0 0 0 0 0 0 16948 0 226429 0 0 0 KEVIN THAO CMO HIGHEST COMPENSATED EMPLOYEE INCENTIVE PACKAGE X 150000 40000 0 0 1 SAMANTHA SEILER HIGHEST COMPENSATED EMPLOYEE INCENTIVE PACKAGE X 50000 6944 0 0 1 46944 FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED BY THE CFO AND CEO AND APPROVED BY THE BOARD OF DIRECTORS BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED BY THE CFO AND THE CEO AND APPROVED BY THE BOARD OF DIRECTORS BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL DIRECTORS AND OFFICERS DISCLOSE ALL INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICTS. THE MEMBERS OF THE GOVERNING BODY MAKE DETERMINATIONS OF WHETHER A CONFLICT EXISTS AND REVIEW ACTUAL CONFLICTS. ANY PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ANNUALLY DETERMINE THE CEO'S COMPENSATION USING DATA ON COMPENSATION PAID BY COMPARABLE ORGANIZATIONS IN SIMILAR COMMUNITIES FOR SIMILAR SERVICES. IN DETERMINING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES, THE PROCESS INCLUDES REVIEW BY THE DIRECTOR OF HUMAN RESOURCES AND APPROVAL OF THE CEO IN ALIGNMENT WITH BOARD APPROVED SALARY SCHEDULES WHICH ARE CREATED USING COMPARABILITY DATA TO ENSURE ALIGNMENT WITH MARKET STANDARDS. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 NOBLE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN COMMUNITY FOUNDATION 28,933. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.