0001567619-20-019144.txt : 20201112 0001567619-20-019144.hdr.sgml : 20201112 20201112085754 ACCESSION NUMBER: 0001567619-20-019144 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201112 DATE AS OF CHANGE: 20201112 EFFECTIVENESS DATE: 20201112 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Ontrak, Inc. CENTRAL INDEX KEY: 0001136174 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 880464853 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-380281 FILM NUMBER: 201303782 BUSINESS ADDRESS: STREET 1: 2120 COLORADO AVE STREET 2: SUITE 230 CITY: SANTA MONICA STATE: CA ZIP: 90404 BUSINESS PHONE: 310 444 4300 MAIL ADDRESS: STREET 1: 2120 COLORADO AVE STREET 2: SUITE 230 CITY: SANTA MONICA STATE: CA ZIP: 90404 FORMER COMPANY: FORMER CONFORMED NAME: CATASYS, INC. DATE OF NAME CHANGE: 20110316 FORMER COMPANY: FORMER CONFORMED NAME: HYTHIAM, INC. DATE OF NAME CHANGE: 20101029 FORMER COMPANY: FORMER CONFORMED NAME: HYTHIAM INC DATE OF NAME CHANGE: 20031003 D 1 primary_doc.xml X0708 D LIVE 0001136174 Ontrak, Inc. 2120 Colorado Ave. Suite 230 Santa Monica CA CALIFORNIA 90404 18665171414 DELAWARE Alaska Freightways Inc. Hythiam, Inc. Catasys, Inc. CATASYS, INC. HYTHIAM, INC. HYTHIAM INC Corporation true Terren S. Peizer Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Executive Officer Chairman of the Board and CEO Richard A. Berman Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Gus Giraldo Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Katherine B. Quinn Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Rob Rebak Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Diane Seloff Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Michael Sherman Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Edward Zecchini Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Curt Medeiros Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer President & Chief Operating Officer Brandon H. LaVerne Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Financial Officer Other Health Care Decline to Disclose 06b false 2020-10-28 false true true true Common stock, including rights granted to receive Stock Consideration in the merger true 0 4636261 4636261 0 Amts rounded up true 4 18 0 0 0 false Ontrak, Inc. /s/ Brandon H. LaVerne Chief Financial Officer 2020-11-11