0001556494-12-000001.txt : 20120828 0001556494-12-000001.hdr.sgml : 20120828 20120827205359 ACCESSION NUMBER: 0001556494-12-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120828 DATE AS OF CHANGE: 20120827 EFFECTIVENESS DATE: 20120828 FILER: COMPANY DATA: COMPANY CONFORMED NAME: EBH HOLDING COMPANY, INC. CENTRAL INDEX KEY: 0001556494 IRS NUMBER: 900770370 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-183308 FILM NUMBER: 121058223 BUSINESS ADDRESS: STREET 1: 5000 E. SPRING STREET, SUITE 650 CITY: LONG BEACH STATE: CA ZIP: 90815 BUSINESS PHONE: 562-741-6470 MAIL ADDRESS: STREET 1: 5000 E. SPRING STREET, SUITE 650 CITY: LONG BEACH STATE: CA ZIP: 90815 D 1 primary_doc.xml X0706 D LIVE 0001556494 EBH HOLDING COMPANY, INC. 5000 E. SPRING STREET, SUITE 650 LONG BEACH CA CALIFORNIA 90815 562-741-6470 DELAWARE None None Corporation true 2011 DAVID SACK C/O ELEMENTS BEHAVIORAL HEALTH, INC. 5000 E. SPRING STREET, SUITE 650 LONG BEACH CA CALIFORNIA 90815 Executive Officer Director DAVID KOSLOFF c/o Frazier Healthcare Ventures 601 Union, Two Union Square, Suite 3200 Seattle WA WASHINGTON 98101 Director Thomas Cooper C/O ELEMENTS BEHAVIORAL HEALTH, INC. 5000 E. SPRING STREET, SUITE 650 LONG BEACH CA CALIFORNIA 90815 Director Mohamad Makhzoumi c/o New Enterprise Associates 2855 Sand Hill Road Menlo Park CA CALIFORNIA 94025 Director Nader Naini c/o Frazier Healthcare Ventures 601 Union, Two Union Square, Suite 3200 Seattle WA WASHINGTON 98101 Director Richard Whitney c/o Whitney Capital Investors 5 LLC 624 Ninth Street Manhattan Beach CA CALIFORNIA 90266 Director Rob Mahan C/O ELEMENTS BEHAVIORAL HEALTH, INC. 5000 E. SPRING STREET, SUITE 650 LONG BEACH CA CALIFORNIA 90815 Executive Officer Other Health Care Decline to Disclose 06 false 2012-08-15 false true false 0 10025000 10000000 25000 false 13 0 0 0 false EBH HOLDING COMPANY, INC. /S/ ROB MAHAN ROB MAHAN CHIEF FINANCIAL OFFICER 2012-08-23