0001582022-16-000001.txt : 20160111 0001582022-16-000001.hdr.sgml : 20160111 20160108180015 ACCESSION NUMBER: 0001582022-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160111 DATE AS OF CHANGE: 20160108 EFFECTIVENESS DATE: 20160111 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Mental Health Data Services, Inc. CENTRAL INDEX KEY: 0001582022 IRS NUMBER: 454104624 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-254834 FILM NUMBER: 161334547 BUSINESS ADDRESS: STREET 1: 9736 NE 119TH WAY STREET 2: E419 CITY: KIRKLAND STATE: WA ZIP: 98034 BUSINESS PHONE: 425-968-5351 MAIL ADDRESS: STREET 1: 9736 NE 119TH WAY STREET 2: E419 CITY: KIRKLAND STATE: WA ZIP: 98034 D 1 primary_doc.xml X0707 D LIVE 0001582022 Mental Health Data Services, Inc. 13005 NE 182nd Place #B Bothell WA WASHINGTON 98011 425-968-5351 WASHINGTON None None Corporation true 2011 Corey Fagan 13005 NE 182nd Place #B Bothell WA WASHINGTON 98011 Executive Officer Director Jon Hauser 13005 NE 182nd Place #B Bothell WA WASHINGTON 98011 Executive Officer Director Eric Meier 13005 NE 182nd Place #B Bothell WA WASHINGTON 98011 Executive Officer Todd Lowdon 13005 NE 182nd Place #B Bothell WA WASHINGTON 98011 Executive Officer Nicholas Talbott 13005 NE 182nd Place #B Bothell WA WASHINGTON 98011 Executive Officer Other Health Care Decline to Disclose 06b false true false true true false 50000 750000 0 750000 false 0 0 0 0 false Mental Health Data Services, Inc. Todd Lowdon Todd Lowdon CFO 2016-01-08