0001678079-19-000001.txt : 20190816 0001678079-19-000001.hdr.sgml : 20190816 20190816161607 ACCESSION NUMBER: 0001678079-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190816 DATE AS OF CHANGE: 20190816 EFFECTIVENESS DATE: 20190816 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: 021-346811 FILM NUMBER: 191033659 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 X0708 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 Michele Strauch 1380 Aspen Way Delta CO COLORADO 81416 Director Regional Director Elvar Olafsson 990 Reserve Drive Suite 240 roseville CA CALIFORNIA 95678 Director Board Member Other Health Care $1,000,001 - $5,000,000 06b false true false true false 25000 4000000 0 4000000 true 0 0 0 true 0 true 0 false Crossroads at Delta Memory Kenneth Weiss Kenneth Weiss Vice-Pres/Sec 2019-08-16