0001582022-20-000004.txt : 20200916 0001582022-20-000004.hdr.sgml : 20200916 20200916165927 ACCESSION NUMBER: 0001582022-20-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200916 DATE AS OF CHANGE: 20200916 EFFECTIVENESS DATE: 20200916 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Mental Health Data Services, Inc. CENTRAL INDEX KEY: 0001582022 IRS NUMBER: 454104624 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-375698 FILM NUMBER: 201179365 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 1 primary_doc.xml X0708 D LIVE 0001582022 Mental Health Data Services, Inc. 3025 SW 1ST AVENUE PORTLAND OR OREGON 97201 800-910-6769 DELAWARE None None Corporation true 2020 Eric Meier 3025 SW 1ST AVENUE PORTLAND OR OREGON 97201 Executive Officer Director Kari Minton 3025 SW 1st Avenue Portland OR OREGON 97201 Executive Officer Stephen Plume 3025 SW 1ST AVENUE PORTLAND OR OREGON 97201 Director Victor Kats 3025 SW 1ST AVENUE PORTLAND OR OREGON 97201 Director Thomas Hawes 3025 SW 1ST AVENUE PORTLAND OR OREGON 97201 Director Jonathan R. Phillips 3025 SW 1ST AVENUE PORTLAND OR OREGON 97201 Director Other Health Care Decline to Disclose 06b false 2020-09-01 false true true true false 0 15480765 15480765 0 Actual Total Offering Amount $15,480,764.58; Actual total Amount Sold: $15,480,764.58 false 31 0 0 0 false Mental Health Data Services, Inc. /s/ Eric Meier Eric Meier Chief Executive Officer 2020-09-16