0001571030-17-000001.txt : 20170807 0001571030-17-000001.hdr.sgml : 20170807 20170807171347 ACCESSION NUMBER: 0001571030-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 504(b)(1) (not (i), (ii) or (iii)) ITEM INFORMATION: 06b FILED AS OF DATE: 20170807 DATE AS OF CHANGE: 20170807 EFFECTIVENESS DATE: 20170807 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Brain Synergy Institute, LLC CENTRAL INDEX KEY: 0001571030 IRS NUMBER: 455533423 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-292283 FILM NUMBER: 171012564 BUSINESS ADDRESS: STREET 1: P.O. BOX 1965 CITY: COPPELL STATE: TX ZIP: 75019 BUSINESS PHONE: (877) 680-8470 MAIL ADDRESS: STREET 1: P.O. BOX 1965 CITY: COPPELL STATE: TX ZIP: 75019 D 1 primary_doc.xml X0708 D LIVE 0001571030 Brain Synergy Institute, LLC 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 2147718885 TEXAS None None Limited Liability Company true Jimmy Mathews 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Executive Officer Director President and Manager Lou Paletta 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Director Chair of Board of Managers Kenneth Beam 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Director Manager Gary C Randall 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Executive Officer Director Manager and Chief Clinical Officer Norine Yukon 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Director Manager Ralph Searfoss 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Director Manager Victor Sansone 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Director Manager Thomas Morgan 11511 Luna Road Suite 100 Farmers Branch TX TEXAS 75234 Director Manager Other Health Care Decline to Disclose 04 06b false 2017-07-24 false true false 0 1000000 484230 515770 false 10 0 0 0 false Brain Synergy Institute, LLC Liza Farrow-Gillespie Liza Farrow-Gillespie Attorney in Fact 2017-08-07