0001582022-17-000001.txt : 20170512 0001582022-17-000001.hdr.sgml : 20170512 20170512170225 ACCESSION NUMBER: 0001582022-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170512 DATE AS OF CHANGE: 20170512 EFFECTIVENESS DATE: 20170512 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: 021-286686 FILM NUMBER: 17839672 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. 3025 SW 1st Avenue Portland OR OREGON 97201 206-931-2632 WASHINGTON None None Corporation true Eric Meier 3025 SW 1st Avenue Portland OR OREGON 97201 Executive Officer Director Todd Lowdon 3025 SW 1st Avenue Portland OR OREGON 97201 Executive Officer Corey Fagan 3025 SW 1st Avenue Portland OR OREGON 97201 Director Salvatore DeTrane 3025 SW 1st Avenue Portland OR OREGON 97201 Director Arnold Silverman 3025 SW 1st Avenue Portland OR OREGON 97201 Director Jeffrey T. Webber 3025 SW 1st Avenue Portland OR OREGON 97201 Director Other Health Care Decline to Disclose 06b false 2017-05-01 false true false 50000 1943178 533000 1410178 false 6 0 0 0 false Mental Health Data Services, Inc. /s/ Eric Meier Eric Meier President 2017-05-12