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ENLIVENING MENTAL HEALTH - ADDED 2021 0423 Date:Apr 22, 2021Page: 1 In City Limits:YesEndorsement Status:PendingStatus Reason: Location Information Business Structure: Nonprofit Corporation UBI Number: 604726169-001-0001 Legal Entity Name: ENLIVENING MENTAL HEALTH Application ID:502126432 Firm Name: ENLIVENING MENTAL HEALTH Application Date:Mar 31, 2021 Location Phone:(253) 249-5991 Fees:35.00 Location Fax: Expiration Date: Mar 31, 2022 Email Address:TRACI@ENLIVENINGMH.ORG Business Open Date:Apr 1, 2021 Location Address: 106 PLAZA DR SE BLDG B3 YELM WA 98597-8841 Mail Address:106 PLAZA DR SE BLDG B3 YELM WA 98597-8841 Product/Serv Description: Mental Health Counselor, Counseling Service, Counselor, Psychotherapist. City Endorsement Information Previous Business License: Number of rental units: 1 Interior/Exterior Modifications: Yes General Specialty Contractor #: Square Footage: 800 Gross Income:$150,000.00 Number of full-time employees at this location:3 Number of part-time employees at this location:0 LF60890982 WA State professional/occupational license:Marriage and Family Therapist Conducting Business From Residence:No Customers Visiting Premises?NoPer Week: 0 Business Activities: Hazardous Materials: (253) 249-5991 Emergency Contact 1:TRACI TOLLIVER Emergency Contact 2: Alarm Monitoring Service?No Company: Contact: Contact Phone: Previous Business Owner?NoName: Firm name: Yelm General Business604726169-001-0001 Date:Apr 22, 2021Page: 2 Phone: Other Location Endorsements Industrial InsuranceActive Unemployment InsuranceActive Approval Information 4/22/2021 Zoning ___________________________________ Fire ___________________________________ DateDate Building ___________________________________ Police ___________________________________ Date Date Finance __________________________________ Planning __________________________________ Date Date Comments: 604726169-001-0001 Yelm General Business