0001567619-21-020097.txt : 20211112 0001567619-21-020097.hdr.sgml : 20211112 20211112172817 ACCESSION NUMBER: 0001567619-21-020097 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211112 DATE AS OF CHANGE: 20211112 EFFECTIVENESS DATE: 20211112 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-380281 FILM NUMBER: 211405029 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/A 1 primary_doc.xml X0708 D/A LIVE 0001136174 Ontrak, Inc. 2120 COLORADO AVE SUITE 230 SANTA MONICA CA CALIFORNIA 90404 310 444 4300 DELAWARE Alaska Freightways Inc CATASYS, INC. HYTHIAM, INC. HYTHIAM INC Corporation true Terren S. Peizer Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Director Executive Chairman Richard A. Berman Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Gustavo A. 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 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 J. Zecchini Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Brandon H. LaVerne Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Financial Officer Jonathan Mayhew Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Executive Officer Robert Newton Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer General Counsel and Secretary James J. Park Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Accounting Officer Mary Louise Osborne Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Customer Officer Arik Hill Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Information Officer Robert Accordino Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Executive Officer Chief Medical Officer Robert H. Rebak Ontrak, Inc. 2120 Colorado Ave., Ste 230 Santa Monica CA CALIFORNIA 90404 Director Other Health Care Decline to Disclose 06b true 0001567619-20-019144 2020-10-28 false true true true Common stock, including rights granted to receive Stock Consideration in the merger true 0 6436495 6079118 357377 Amts rounded up true 6 21 0 0 0 false Ontrak, Inc. /s/Brandon H. LaVerne Brandon H. LaVerne Chief Financial Officer 2021-11-12