0001656672-15-000001.txt : 20151027 0001656672-15-000001.hdr.sgml : 20151027 20151027140756 ACCESSION NUMBER: 0001656672-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20151027 DATE AS OF CHANGE: 20151027 EFFECTIVENESS DATE: 20151027 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Park Boulevard Memory Care, LLC CENTRAL INDEX KEY: 0001656672 IRS NUMBER: 371791631 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-250142 FILM NUMBER: 151177515 BUSINESS ADDRESS: STREET 1: 111 MARKET STREET NE, SUITE 200 CITY: OLYMPIA STATE: WA ZIP: 98501 BUSINESS PHONE: 360-867-1900 MAIL ADDRESS: STREET 1: 111 MARKET STREET NE, SUITE 200 CITY: OLYMPIA STATE: WA ZIP: 98501 D 1 primary_doc.xml X0707 D LIVE 0001656672 Park Boulevard Memory Care, LLC 111 MARKET STREET NE, SUITE 200 OLYMPIA WA WASHINGTON 98501 360-867-1900 DELAWARE None None Limited Liability Company true 2014 a Washington LLC Glen Ellyn Koelsch, LLC 111 Market Street NE, Suite 200 Olympia WA WASHINGTON 98501 Executive Officer Managing Member of the Issuer Aaron Koelsch 111 Market Street, Suite 200 Olympia WA WASHINGTON 98501 Executive Officer Other Health Care No Revenues 06b false 2015-10-15 false true false 70498 3524925 3524925 0 false 12 0 0 0 false Park Boulevard Memory Care, LLC Aaron Koelsch Aaron Koelsch Managing Member of Managing Member of Issuer 2015-10-27