0001678079-16-000001.txt : 20160708 0001678079-16-000001.hdr.sgml : 20160708 20160708132657 ACCESSION NUMBER: 0001678079-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160708 DATE AS OF CHANGE: 20160708 EFFECTIVENESS DATE: 20160708 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Crossroads at Delta Memory CENTRAL INDEX KEY: 0001678079 IRS NUMBER: 471262846 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-266627 FILM NUMBER: 161758660 BUSINESS ADDRESS: STREET 1: 990 RESERVE DRIVE STREET 2: SUITE 240 CITY: ROSEVILLE STATE: CA ZIP: 95678 BUSINESS PHONE: 9167747700 MAIL ADDRESS: STREET 1: 990 RESERVE DRIVE STREET 2: SUITE 240 CITY: ROSEVILLE STATE: CA ZIP: 95678 D 1 primary_doc.xml X0707 D LIVE 0001678079 Crossroads at Delta Memory 990 RESERVE DRIVE SUITE 240 ROSEVILLE CA CALIFORNIA 95678 9167747700 COLORADO None None Other Non-Profit true 2014 Don Noble 990 Reserve Drive Suite 100 Roseville CA CALIFORNIA 95678 Executive Officer Director President Kenneth Weiss 990 Reserve Drive Suite 100 Roseville CA CALIFORNIA 95678 Executive Officer Director Vice-President/ Secretary Susan Bushnell 990 Reserve Drive Suite 100 Roseville CA CALIFORNIA 95678 Executive Officer Director CFO Donald Lloyd 990 Reserve Drive Suite 240 Roseville CA CALIFORNIA 95678 Director Board Member Diane Obermeyer 1380 Aspen Way Delta CO COLORADO 81416 Executive Officer Executive Director Rick Roedel 1380 Aspen Way Delta CO COLORADO 81416 Executive Officer Regional Vice-President Other Health Care $1 - $1,000,000 06b false 2016-06-29 false true false 25000 4000000 250000 3750000 true 0 2 0 true 0 true 0 false Crossroads at Delta Memory Kenneth Weiss Kenneth Weiss Vice-Pres/Sec 2016-07-08