0001556494-13-000002.txt : 20131028 0001556494-13-000002.hdr.sgml : 20131028 20131025185542 ACCESSION NUMBER: 0001556494-13-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20131028 DATE AS OF CHANGE: 20131025 EFFECTIVENESS DATE: 20131028 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: 021-205328 FILM NUMBER: 131171743 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 X0707 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 Jim Adams 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 06b false 2013-08-27 false true false 0 82500 82500 0 false 2 0 0 0 false EBH HOLDING COMPANY, INC. /s/ Jim Adams JIM ADAMS CHIEF FINANCIAL OFFICER 2013-10-16