﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2024v5.5">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2026-04-16T15:46:42-05:00</ReturnTs>
    <TaxPeriodEndDt>2025-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>042571780</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>AAFCPAS INC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>50 WASHINGTON STREET</AddressLine1Txt>
        <CityNm>WESTBOROUGH</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01581</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>042174657</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>RIVER VALLEY COUNSELING CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>RIVE</BusinessNameControlTxt>
      <PhoneNum>4135401234</PhoneNum>
      <USAddress>
        <AddressLine1Txt>187 HIGH STREET</AddressLine1Txt>
        <CityNm>HOLYOKE</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01040</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ERIN SPAULDING</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>4135401234</PhoneNum>
      <SignatureDt>2026-04-15</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>JUSTIN K LEROUX CPA</PreparerPersonNm>
      <PTIN>P01722988</PTIN>
      <PhoneNum>5083669100</PhoneNum>
      <PreparationDt>2026-04-15</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001" accountingPeriodChangeCd="CHANGE OF ACCOUNTING PERIOD" accountingPeriodChangeApprvCd="REVENUE PROCEDURE 85-58 RULES APPLY">
      <PrincipalOfficerNm>ROSEMARIE ANSEL</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>187 HIGH STREET</AddressLine1Txt>
        <CityNm>HOLYOKE</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01040</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>22628028</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.RVCCINC.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1953</FormationYr>
      <LegalDomicileStateCd>MA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>CHARITABLE OUTPATIENT MENTAL HEALTH</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>10</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>7</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>444</TotalEmployeeCnt>
      <TotalVolunteersCnt>30</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>448712</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>2482894</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>26907221</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>19962399</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>98935</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>93638</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>24172</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>89097</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>27479040</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>22628028</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>20585182</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>16062698</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>6222657</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>4181558</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>26807839</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>20244256</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>671201</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>2383772</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>8875348</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>6386220</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>7789400</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3837483</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>1085948</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>2548737</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>CHARITABLE OUTPATIENT MENTAL HEALTH</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>16257974</ExpenseAmt>
      <RevenueAmt>20051496</RevenueAmt>
      <Desc>PROVIDED OUTPATIENT BEHAVIORAL HEALTH SERVICES; EAP SERVICES; SUBSTANCE ABUSE COUNSELING AND PREVENTION SERVICES; AND HIV/AIDS SOCIAL SUPPORT SERVICES INCLUDING: TREATMENT, TESTING, CONSULTATION, PSYCHOPHARMACOLOGY, CASE MANAGEMENT, AND HOUSING SUPPORTS.</Desc>
      <TotalProgramServiceExpensesAmt>16257974</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>39</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>444</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>10</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>7</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>1</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>THE ORGANIZATION</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>4135401100</PhoneNum>
        <USAddress>
          <AddressLine1Txt>187 HIGH STREET</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>SPIRIDON E HATIRAS</PersonNm>
        <TitleTxt>DIRECTOR, EX OFFICIO</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>47.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>906011</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>77893</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CARL CAMERON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>42.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>499662</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45351</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEAN VITARISI</PersonNm>
        <TitleTxt>TREASURER &amp; CFO</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>42.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>380743</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>48873</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF HAYDEN</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS OCONNOR</PersonNm>
        <TitleTxt>CLERK</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL HANNOUSH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREG SHEEHAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VALERIE BURDON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL COYNE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELISSA PERRY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BARBARA FONTAINE</PersonNm>
        <TitleTxt>DIRECTOR (UNTIL 1/25)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROSEMARIE ANSEL</PersonNm>
        <TitleTxt>EXECUTIVE DIR. &amp; DIR., EX-OFFICIO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>288474</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11261</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIN SPAULDING</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>151048</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14892</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN ROMM REUBEN</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>250727</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5171</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELAINE CAMPBELL</PersonNm>
        <TitleTxt>ASSISTANT EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>171517</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8400</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHELDON L HOLLINS</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>179690</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>62</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>OLGA FIGUEROA</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>151401</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>62</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAULA TOFTE</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <AverageHoursPerWeekRt>30.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>139642</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9602</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>892977</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2225938</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>221567</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>17</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BEHAVIORAL HEALTH RCM SOLUTIONS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4083 LEES CHAPEL RD</AddressLine1Txt>
            <CityNm>CEDAR GROVE</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27231</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BILLING CONSULTANT</ServicesDesc>
        <CompensationAmt>1204303</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>1790024</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>692870</AllOtherContributionsAmt>
      <TotalContributionsAmt>2482894</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>19962399</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>19962399</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>19962399</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>93638</TotalRevenueColumnAmt>
        <ExclusionAmt>93638</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>89097</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>89097</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>89097</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>22628028</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>20051496</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>93638</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>13096216</TotalAmt>
        <ProgramServicesAmt>11595527</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1500689</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>60970</TotalAmt>
        <ProgramServicesAmt>42760</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18210</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1933188</TotalAmt>
        <ProgramServicesAmt>1204825</ProgramServicesAmt>
        <ManagementAndGeneralAmt>728363</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>972324</TotalAmt>
        <ProgramServicesAmt>681913</ProgramServicesAmt>
        <ManagementAndGeneralAmt>290411</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>408536</TotalAmt>
        <ManagementAndGeneralAmt>408536</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>11732</TotalAmt>
        <ManagementAndGeneralAmt>11732</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>34259</TotalAmt>
        <ManagementAndGeneralAmt>34259</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>26328</TotalAmt>
        <ProgramServicesAmt>26328</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>942456</TotalAmt>
        <ProgramServicesAmt>564346</ProgramServicesAmt>
        <ManagementAndGeneralAmt>378110</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>121260</TotalAmt>
        <ProgramServicesAmt>73933</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47327</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>39017</TotalAmt>
        <ProgramServicesAmt>23789</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15228</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>44267</TotalAmt>
        <ProgramServicesAmt>26990</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17277</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>778962</TotalAmt>
        <ProgramServicesAmt>642704</ProgramServicesAmt>
        <ManagementAndGeneralAmt>136258</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>118760</TotalAmt>
        <ProgramServicesAmt>72409</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46351</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>1571</TotalAmt>
        <ProgramServicesAmt>958</ProgramServicesAmt>
        <ManagementAndGeneralAmt>613</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>117128</TotalAmt>
        <ProgramServicesAmt>87072</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30056</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>110770</TotalAmt>
        <ProgramServicesAmt>67537</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43233</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CLIENT CARE EXPENSES</Desc>
        <TotalAmt>658108</TotalAmt>
        <ProgramServicesAmt>658108</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BILLING SERVICES</Desc>
        <TotalAmt>422752</TotalAmt>
        <ProgramServicesAmt>257755</ProgramServicesAmt>
        <ManagementAndGeneralAmt>164997</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>180905</TotalAmt>
        <ProgramServicesAmt>130572</ProgramServicesAmt>
        <ManagementAndGeneralAmt>50333</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>STAFF DEVELOPMENT</Desc>
        <TotalAmt>65607</TotalAmt>
        <ProgramServicesAmt>40001</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25606</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>99140</TotalAmt>
        <ProgramServicesAmt>60447</ProgramServicesAmt>
        <ManagementAndGeneralAmt>38693</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>20244256</TotalAmt>
        <ProgramServicesAmt>16257974</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3986282</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1118194</BOYAmt>
        <EOYAmt>839294</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>3517163</BOYAmt>
        <EOYAmt>2735801</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>869781</BOYAmt>
        <EOYAmt>715263</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1361514</BOYAmt>
        <EOYAmt>184760</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>378777</BOYAmt>
        <EOYAmt>135842</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>2906000</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2064826</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>855455</BOYAmt>
        <EOYAmt>841174</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>774464</BOYAmt>
        <EOYAmt>934086</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>8875348</BOYAmt>
        <EOYAmt>6386220</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>3469021</BOYAmt>
        <EOYAmt>1947309</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>4320379</BOYAmt>
        <EOYAmt>1890174</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>7789400</BOYAmt>
        <EOYAmt>3837483</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1085948</BOYAmt>
        <EOYAmt>2548737</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1085948</BOYAmt>
        <EOYAmt>2548737</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>8875348</BOYAmt>
        <EOYAmt>6386220</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>2383772</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-920983</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>2055972</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>105611</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>33266</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>448712</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2482894</CurrentTaxYearAmt>
        <TotalAmt>5126455</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>18502207</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>25937039</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27811840</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>26907221</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>19962399</CurrentTaxYearAmt>
        <TotalAmt>119120706</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>20558179</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>26042650</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27845106</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27355933</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>22445293</CurrentTaxYearAmt>
        <TotalAmt>124247161</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>124247161</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>773</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>704</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1309</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>98935</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>93638</CurrentTaxYearAmt>
        <TotalAmt>195359</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>773</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>704</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1309</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>98935</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>93638</CurrentTaxYearAmt>
        <TotalAmt>195359</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearAmt>89097</CurrentTaxYearAmt>
        <TotalAmt>89097</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>20558952</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>26043354</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27846415</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27454868</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>22628028</CurrentTaxYearAmt>
        <TotalAmt>124531617</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99770</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99890</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00160</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00080</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME - 2024 AMOUNT: $ 89,097.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART III, SHORT YEAR EXPLANATION:</FormAndLineReferenceDesc>
        <ExplanationTxt>RIVER VALLEY COUNSELING CENTER, INC. IS FILING A SHORT-YEAR RETURN FOR THE PERIOD BEGINNING OCTOBER 1, 2024 AND ENDING JUNE 30, 2025 DUE TO A CHANGE IN ACCOUNTING PERIOD.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>1</GrantsOtherOrganizationsInd>
      <GrantsOtherOrganizationsAmt>26328</GrantsOtherOrganizationsAmt>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>0</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>26328</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS A MEMBER OF THE ASSOCIATION FOR BEHAVIORAL HEALTHCARE (ABH). ABH PROMOTES AND ADVOCATES FOR COMMUNITY-BASED MENTAL HEALTH AND ADDICTION TREATMENT SERVICE. AS A MEMBER OF THE ABH, THE ORGANIZATION PAYS DUES TO THE ASSOCIATION, A PORTION OF WHICH MAY BE USED FOR LOBBYING PURPOSES. THE TOTAL DUES PAID TO THE ASSOCIATION DURING THE PAST FISCAL YEAR WAS $26,328. AN EXACT AMOUNT OF THE DUES USED FOR LOBBYING IS NOT AVAILABLE. ACCORDINGLY, THE ENTIRE AMOUNT OF DUES PAID DURING THE YEAR HAS BEEN DISCLOSED ON THIS FORM 990, SCHEDULE C, FOR TRANSPARENCY PURPOSES. IT IS LIKELY THAT THE ACTUAL PORTION OF DUES USED FOR LOBBYING PURPOSES WAS SIGNIFICANTLY LESS THAN THE TOTAL DUES PAID.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>10343</OtherCostOrOtherBasisAmt>
        <BookValueAmt>10343</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1685380</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1223333</DepreciationAmt>
        <BookValueAmt>462047</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1210277</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>841493</DepreciationAmt>
        <BookValueAmt>368784</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>841174</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT-OF-USE ASSET - OPERATING</Desc>
        <BookValueAmt>934086</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>934086</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>957179</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE LIABILITIES</Desc>
        <Amt>932995</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1890174</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>22628028</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>22628028</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>22628028</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>21165239</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>920983</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>920983</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>20244256</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>20244256</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AGENCY ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH ASC TOPIC, INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENTS REGARDING A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE AGENCY HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS WHICH QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS AT JUNE 30, 2025. THE AGENCY'S INFORMATION RETURNS ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE JURISDICTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>EQUITY TRANSFER 920,983.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SPIRIDON E HATIRAS</PersonNm>
        <TitleTxt>DIRECTOR, EX OFFICIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>906011</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>56334</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>21559</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>983904</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CARL CAMERON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>499662</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>30299</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15052</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>545013</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DEAN VITARISI</PersonNm>
        <TitleTxt>TREASURER &amp; CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>380743</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>26932</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>21941</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>429616</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROSEMARIE ANSEL</PersonNm>
        <TitleTxt>EXECUTIVE DIR. &amp; DIR., EX-OFFICIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>288474</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>2285</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>8976</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>299735</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUSAN ROMM REUBEN</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>250727</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>2830</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2341</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>255898</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELAINE CAMPBELL</PersonNm>
        <TitleTxt>ASSISTANT EXECUTIVE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>156164</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15353</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8400</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>179917</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHELDON L HOLLINS</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <BaseCompensationFilingOrgAmt>179690</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>62</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>179752</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIN SPAULDING</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>151048</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>1560</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13332</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>165940</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>OLGA FIGUEROA</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <BaseCompensationFilingOrgAmt>151401</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>62</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>151463</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND EXECUTIVE DIRECTOR WAS ESTABLISHED BY A RELATED ORGANIZATION, VALLEY HEALTH SYSTEMS, INC. THAT ORGANIZATION ESTABLISHED THE CEO'S COMPENSATION BY USING A COMPENSATION COMMITTEE AND A COMPENSATION STUDY. THE COMPENSATION WAS ALSO APPROVED BY THE SYSTEM'S COMPENSATION COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>HOLYOKE MEDICAL CENTER ADOPTED A 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT BECAME EFFECTIVE AS OF JULY 1, 2017. THE PLAN ALLOWS FOR ELIGIBLE INDIVIDUALS AND EMPLOYEES OF THE MEDICAL CENTER TO RECEIVE BENEFITS UNDER THE PLAN UNTIL THE ATTAINMENT OF AGE 65. NON-ELECTIVE CONTRIBUTIONS MADE FOR A PLAN PARTICIPANT ARE TRACKED AND WILL VEST SEPARATELY BASED ON ANNIVERSARIES OF PARTICIPANTS' EMPLOYMENT. EACH CONTRIBUTION WILL BE 0% VESTED UNTIL THE PARTICIPANT REACHES THE END OF THEIR SECOND YEAR OF EMPLOYMENT AFTER EACH CONTRIBUTION. EACH CONTRIBUTION WILL BECOME 100% VESTED AS OF THE LAST DAY OF THE 2ND YEAR OF A PARTICIPANT'S EMPLOYMENT, IF THE PARTICIPANT IS STILL EMPLOYED ON THAT DATE. ONLY ELIGIBLE EMPLOYEES ARE PARTICIPANTS IN THE PLAN, AND THE PLAN DOES NOT ALLOW FOR EMPLOYEE ELECTIVE DEFERRALS OR EMPLOYER MATCHES. FOR THE 2024 TAX YEAR, THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS UNDER THE 457(F) PLAN: - SPIRIDON E. HATIRAS, $52,884. - CARL CAMERON, $30,299. AND, - DEAN VITARISI, $23,482.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>CERTAIN OFFICERS AND DIRECTORS OF RIVER VALLEY COUNSELING CENTER, INC. ARE EMPLOYED BY A RELATED TAX-EXEMPT ORGANIZATION WHICH HAS COMMON OFFICERS AND/OR DIRECTORS. BY VIRTUE OF THIS ARRANGEMENT, CERTAIN INDIVIDUALS LISTED IN FORM 990, PART VII HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER OF THE ORGANIZATION IS VALLEY HEALTH SYSTEMS, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS AT THE ORGANIZATION SHALL CONSIST OF NO LESS THAN FIVE (5) NOR MORE THAN TWELVE (12) MEMBERS. THE DIRECTORS SHALL BE ELECTED BY THE SOLE MEMBER, VALLEY HEALTH SYSTEMS, INC. IN ADDITION, THE PRESIDENT OF THE MEMBER, OR HIS/HER DESIGNEE, SHALL BE AN EX-OFFICIO MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS. FURTHERMORE, THE SOLE MEMBER APPOINTS THE CENTER'S EXECUTIVE DIRECTOR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNIFICANT DECISIONS OF THE GOVERNING BODY OF RIVER VALLEY COUNSELING CENTER, INC. ARE SUBJECT TO THE APPROVAL OF VALLEY HEALTH SYSTEMS, INC. AS SPECIFIED IN THE ORGANIZATION'S BYLAWS. SUCH DECISIONS INCLUDE: - APPROVAL OF THE ANNUAL BUDGETS; - SELECTION OF THE ORGANIZATION'S INDEPENDENT PUBLIC ACCOUNTING FIRM ENGAGED TO CONDUCT THE ANNUAL AUDIT; - SALE, ASSIGNMENT, AND/OR TRANSFER OF PROPERTY IN EXCESS OF $10,000; - MERGER OR CONSOLIDATION OF THE CENTER WITH ANOTHER ORGANIZATION OR ENTITY; - BRORROWINGS OR FINANCING IN EXCESS OF $50,000; - CHANGES IN THE STRATEGIC FOCUS OR MISSION OF THE CENTER; - CHANGES IN THE ARTICLES OR BYLAWS OF THE CENTER; - APPOINTMENT OF THE EXECUTIVE DIRECTOR; AND - APPROVAL OF COMPLIANCE AND QUALITY PROGRAMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD REVIEWS AND APPROVES THE FORM 990 BEFORE IT IS FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY OF RIVER VALLEY COUNSELING CENTER, INC. (RVCC) IS MONITORED AND ENFORCED AS PART OF THE VALLEY HEALTH SYSTEMS, INC. SYSTEM AND IS REVIEWED ANNUALLY BY THE SYSTEM'S CONFLICT OF INTEREST COMMITTEE. RVCC BOARD MEMBERS AND OFFICERS COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ALL SIGNED QUESTIONNAIRES ARE THEN SUBMITTED TO RVCC AND TO VALLEY HEALTH SYSTEMS, INC. (PARENT) FOR REVIEW AND MONITORING. ANY MEMBER OF THE BOARD WHO HAS A FINANCIAL, PERSONAL, OFFICIAL, OR DUALITY OF INTEREST IN, OR CONFLICT OR APPEARING OF A CONFLICT WITH ANY MATTER PENDING BEFORE THE BOARD OF SUCH NATURE THAT IT PREVENTS OR MAY PREVENT THAT MEMBER FROM ACTING ON THE MATTER IN AN IMPARTIAL MANNER, WILL OFFER TO THE BOARD TO VOLUNTARILY EXCUSE HIMSELF AND WILL VACATE HIS SEAT AND REFRAIN FROM DISCUSSION AND VOTING ON SAID ITEM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION COMMITTEE OF VALLEY HEALTH SYSTEM, INC. UTILIZES A MARKET COMPENSATION SURVEY TO RECOMMEND TO THE BOARD THE APPROVAL OF ITS DETERMINATION OF THE APPROPRIATE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. DURING THAT PROCESS, THE COMMITTEE ALSO REVIEWS THE COMPENSATION LEVELS OF OTHER SENIOR MANAGEMENT AND KEY EMPLOYEES OF THE SYSTEM. THESE INDIVIDUALS ARE NOT MEMBERS OF THE COMPENSATION COMMITTEE AND DO NOT PARTICIPATE IN THIS PROCESS. THE CEO, AS A MEMBER OF THE BOARD OF VHS, DOES NOT PARTICIPATE IN THE APPROVAL PROCESS OF THAT OFFICER'S COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS OF VALLEY HEALTH SYSTEMS AND AFFILIATES, WHICH INCLUDES SUPPLEMENTAL INFORMATION OF THE FILING ENTITY, ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE AT 575 BEECH STREET, HOLYOKE, MA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>EQUITY TRANSFER -920,983.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY HEALTH FOUNDATION OF WESTERN MASSACHUSETTS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>575 BEECH STREET</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>222568962</EIN>
        <PrimaryActivitiesTxt>RAISE &amp; INVEST FUNS FOR AFFILIATES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HOLYOKE MEDICAL CENTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>575 BEECH STREET</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>222520073</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HOLYOKE VISITING NURSE ASSOCIATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>575 BEECH STREET</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>042104310</EIN>
        <PrimaryActivitiesTxt>HOME HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MASSWEST SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>575 BEECH STREET</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>222515964</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>H-C MANAGEMENT SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>20 HOSPITAL DRIVE</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>222515981</EIN>
        <PrimaryActivitiesTxt>SUPPORTING ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>20 HOSPITAL DRIVE</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>042103583</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WESTERN MASS PHYSICIAN ASSOCIATES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>15 HOSPITAL DRIVE</AddressLine1Txt>
          <CityNm>HOLYOKE</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01040</ZIPCd>
        </USAddress>
        <EIN>043202198</EIN>
        <PrimaryActivitiesTxt>MEDICAL CARE SERVICE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MASSWEST SERVICEINC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WILLIAM SKINNER TUA-HOLYOKE HOSPITAL TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1802</AddressLine1Txt>
          <CityNm>PROVIDENCE</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>029011802</ZIPCd>
        </USAddress>
        <EIN>046035855</EIN>
        <PrimaryActivitiesTxt>GRANTMAKING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>4797 (A) (1)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>PF</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>