<?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="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-07-04T11:02:33-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>872525370</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CITRIN COOPERMAN ADVISORS LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>6550 N FEDERAL HIGHWAY 4TH FLOOR</AddressLine1Txt>
        <CityNm>FT LAUDERDALE</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33308</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>352640151</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MONARCH HEALTH SERVICES INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>MONA</BusinessNameControlTxt>
      <PhoneNum>5615234589</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2580 METROCENTRE BLVD STE 1</AddressLine1Txt>
        <CityNm>WEST PALM BEACH</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33407</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>DAMION BAKER</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>5615234589</PhoneNum>
      <SignatureDt>2024-06-30</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>DAMION</PersonFirstNm>
        <PersonLastNm>BAKER</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>TYLER JOHNSON</PreparerPersonNm>
      <PTIN>P01959117</PTIN>
      <PhoneNum>9547710896</PhoneNum>
      <PreparationDt>2024-06-30</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2023</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="4">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>DAMION BAKER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>2580 METROCENTRE BLVD STE 1</AddressLine1Txt>
        <CityNm>WEST PALM BEACH</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33407</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>17327238</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.MONARCHEALTH.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2018</FormationYr>
      <LegalDomicileStateCd>FL</LegalDomicileStateCd>
      <ActivityOrMissionDesc>MONARCH HEALTH SERVICES INC PROMOTES THE HEALTH OF INDIVIDUALS, FAMILIES, AND COMMUNITIES BY PROVIDING MEDICAL, SOCIAL, AND EDUCATION SERVICES, TO FOSTER HEALTHY LIFESTYLES, BEHAVIORS, AND RELATIONSHIPS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>6</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>6</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>21</TotalEmployeeCnt>
      <TotalVolunteersCnt>10</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>148810</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>513019</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>2357267</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>0</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>3284</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>7743</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>2462090</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>2509361</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>2982852</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1111864</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1147421</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>1553651</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>1494904</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>2665515</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>2642325</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-156154</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>340527</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>1737641</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>2210565</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>676306</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>781724</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>1061335</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>1428841</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>MONARCH HEALTH SERVICES INC PROMOTES THE HEALTH OF INDIVIDUALS, FAMILIES, AND COMMUNITIES BY PROVIDING MEDICAL, SOCIAL, AND EDUCATION SERVICES, TO FOSTER HEALTHY LIFESTYLES, BEHAVIORS, AND RELATIONSHIPS.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>615800</ExpenseAmt>
      <Desc>PROGRAMS AND INTEGRATIVE SERVICES:MONARCH PROVIDES ACCESS AND ENGAGEMENT TO CARE FOR PERSONS LIVING WITH HIV AND/OR DIAGNOSED WITH OTHER STD/STI AND FACILITATES LINKAGE TO OTHER SUPPORT SERVICES.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>1363638</ExpenseAmt>
        <RevenueAmt>2462090</RevenueAmt>
        <Desc>CLINICAL SERVICES:MONARCH PROMOTES THE SEXUAL HEALTH OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY PROVIDING FREE HIV/STD TESTING AND TREATMENT TO ALL.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>232022</ExpenseAmt>
        <Desc>OUTREACH:MONARCH THROUGH OUTREACH EDUCATES AND ENGAGES INDIVIDUALS, FAMILIES AND COMMUNITIES ABOUT HIV/STD PREVENTION AND TESTING TO FOSTER HEALTHY BEHAVIORS AND RELATIONSHIPS AND PREVENT ADVERSE OUTCOMES.</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>2211460</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>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">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</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>0</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>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>7</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>21</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>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>6</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>6</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</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>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>DAMION BAKER</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5615234589</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2580 METROCENTRE BLVD STE 1</AddressLine1Txt>
          <CityNm>WEST PALM BEACH</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33407</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>TRICIA MACCARTHY</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>0.25</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR KARL MICHEL</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>0.25</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDY BOISROND</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.25</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARMAINE BROWN</PersonNm>
        <TitleTxt>HR COMMITTEE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>0.25</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINE LEE-MCLEAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.25</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NASHIKA JACKSON OGLIVE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.25</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAMION BAKER</PersonNm>
        <TitleTxt>CEO / EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>130905</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15482</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VALERIE BROOKS</PersonNm>
        <TitleTxt>CLINICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>126692</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20161</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>257597</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>35643</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>2</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>506994</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>6025</AllOtherContributionsAmt>
      <TotalContributionsAmt>513019</TotalContributionsAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>7458</TotalRevenueColumnAmt>
        <ExclusionAmt>7458</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2844</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>2559</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>285</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>285</TotalRevenueColumnAmt>
        <ExclusionAmt>285</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <GrossSalesOfInventoryAmt>16803917</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>14341827</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>2462090</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2462090</RelatedOrExemptFuncIncomeAmt>
      </NetIncomeOrLossGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>2982852</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2462090</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>7743</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>257597</TotalAmt>
        <ProgramServicesAmt>198350</ProgramServicesAmt>
        <ManagementAndGeneralAmt>59247</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>664890</TotalAmt>
        <ProgramServicesAmt>511965</ProgramServicesAmt>
        <ManagementAndGeneralAmt>152925</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>154064</TotalAmt>
        <ProgramServicesAmt>118630</ProgramServicesAmt>
        <ManagementAndGeneralAmt>35434</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>70870</TotalAmt>
        <ProgramServicesAmt>54570</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16300</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>2559</TotalAmt>
        <ManagementAndGeneralAmt>2559</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>443707</TotalAmt>
        <ProgramServicesAmt>443707</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>16353</TotalAmt>
        <ProgramServicesAmt>16353</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>67825</TotalAmt>
        <ProgramServicesAmt>54603</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13222</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>139524</TotalAmt>
        <ProgramServicesAmt>107433</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32091</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>212886</TotalAmt>
        <ProgramServicesAmt>170309</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42577</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>37413</TotalAmt>
        <ProgramServicesAmt>26189</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11224</ManagementAndGeneralAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>57854</TotalAmt>
        <ProgramServicesAmt>46283</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11571</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>32453</TotalAmt>
        <ProgramServicesAmt>27207</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5246</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CONTRACT SERVICES</Desc>
        <TotalAmt>303139</TotalAmt>
        <ProgramServicesAmt>303139</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OUTREACH</Desc>
        <TotalAmt>71722</TotalAmt>
        <ProgramServicesAmt>71722</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROFESSIONAL DEVELOPMEN</Desc>
        <TotalAmt>34644</TotalAmt>
        <ProgramServicesAmt>26676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7968</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CONSULTANTS</Desc>
        <TotalAmt>33870</TotalAmt>
        <ManagementAndGeneralAmt>33870</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>40955</TotalAmt>
        <ProgramServicesAmt>34324</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6631</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>2642325</TotalAmt>
        <ProgramServicesAmt>2211460</ProgramServicesAmt>
        <ManagementAndGeneralAmt>430865</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>466559</BOYAmt>
        <EOYAmt>648842</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>491224</BOYAmt>
        <EOYAmt>609334</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>12413</BOYAmt>
        <EOYAmt>9146</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>340934</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>157491</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>171197</BOYAmt>
        <EOYAmt>183443</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>253072</BOYAmt>
        <EOYAmt>283420</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>343176</BOYAmt>
        <EOYAmt>476380</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>1737641</BOYAmt>
        <EOYAmt>2210565</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>279157</BOYAmt>
        <EOYAmt>304049</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>48949</BOYAmt>
        <EOYAmt>5000</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>348200</BOYAmt>
        <EOYAmt>472675</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>676306</BOYAmt>
        <EOYAmt>781724</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1061335</BOYAmt>
        <EOYAmt>1428841</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1061335</BOYAmt>
        <EOYAmt>1428841</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>1737641</BOYAmt>
        <EOYAmt>2210565</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>340527</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>26979</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>1946</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>80543</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>200142</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>148760</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>513019</CurrentTaxYearAmt>
        <TotalAmt>944410</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>1946</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>80543</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>200142</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>148760</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>513019</CurrentTaxYearAmt>
        <TotalAmt>944410</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>944410</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus3YearsAmt>311</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>276</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3284</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7743</CurrentTaxYearAmt>
        <TotalAmt>11614</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>956024</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>24531494</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.98790</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99110</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>106356</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>53831</DepreciationAmt>
        <BookValueAmt>52525</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>50046</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>33358</DepreciationAmt>
        <BookValueAmt>16688</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>184532</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>70302</DepreciationAmt>
        <BookValueAmt>114230</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>183443</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DEPOSITS</Desc>
        <BookValueAmt>19014</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHTS OF USE ASSETS, NET</Desc>
        <BookValueAmt>457366</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>476380</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY</Desc>
        <Amt>472675</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>472675</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>3007272</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>26979</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>26979</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>2980293</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>2559</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>2559</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>2982852</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>2639766</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>2639766</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>2559</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>2559</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>2642325</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE OFFICER AND THE BOARD OF DIRECTORS WILL REVIEW THE FORM 990 BEFORE ITS FILING WITH THE TAX AGENCY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS CONSISTENTLY MONITORS THE CONFLICT OF INTEREST POLICY IN ITS REGULAR MEETINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS HAS ESTABLISHED A FINANCIAL COMMITTEE THAT DOES AN ANNUAL EVALUATION OF THE COMPENSATION FOR TOP MANAGEMENT, OFFICERS, OR KEY EMPLOYEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>PROFESSIONAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 443,707. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 443,707.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>NO CHANGE FROM PRIOR YEAR</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
