0001582022-19-000001.txt : 20190215 0001582022-19-000001.hdr.sgml : 20190215 20190215165114 ACCESSION NUMBER: 0001582022-19-000001 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190215 DATE AS OF CHANGE: 20190215 EFFECTIVENESS DATE: 20190215 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-314734 FILM NUMBER: 19612196 BUSINESS ADDRESS: STREET 1: 3025 SW 1ST AVENUE CITY: PORTLAND STATE: OR ZIP: 97201 BUSINESS PHONE: 206-931-2632 MAIL ADDRESS: STREET 1: 3025 SW 1ST AVENUE CITY: PORTLAND STATE: OR ZIP: 97201 D/A 1 primary_doc.xml X0708 D/A 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 Corey Fagan 3025 SW 1st Avenue Portland OR OREGON 97201 Director J. Corey Schmid 3025 SW 1st Avenue Portland OR OREGON 97201 Director Other Health Care Decline to Disclose 06b true 0001582022-18-000004 2018-06-04 false true false Excluding compensation paid to executive officers in the ordinary course of business 0 4482833 2523529 1959304 false 18 0 0 0 false Mental Health Data Services, Inc. /s/ Eric Meier Eric Meier President 2019-02-14