0001678606-16-000001.txt : 20160712 0001678606-16-000001.hdr.sgml : 20160712 20160712150134 ACCESSION NUMBER: 0001678606-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160712 DATE AS OF CHANGE: 20160712 EFFECTIVENESS DATE: 20160712 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Square Care Provider Holdings, LLC CENTRAL INDEX KEY: 0001678606 IRS NUMBER: 812894186 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-266814 FILM NUMBER: 161763862 BUSINESS ADDRESS: STREET 1: 1129 NORTHERN BLVD. STREET 2: SUITE 101 CITY: MANHASSET STATE: NY ZIP: 11030 BUSINESS PHONE: 516-365-5570 MAIL ADDRESS: STREET 1: 1129 NORTHERN BLVD. STREET 2: SUITE 101 CITY: MANHASSET STATE: NY ZIP: 11030 D 1 primary_doc.xml X0707 D LIVE 0001678606 Square Care Provider Holdings, LLC 1129 NORTHERN BLVD. SUITE 101 MANHASSET NY NEW YORK 11030 516-365-5570 DELAWARE None None Limited Liability Company true 2016 Simon Prince 2012 Midlane South Muttontown NY NEW YORK 11791 Executive Officer Promoter Additional individuals to be determined. Pooled Investment Fund Other Investment Fund false No Aggregate Net Asset Value 06b false true true true true true Convertible Promissory Notes (automatically converts into Units of the Company) false 10000 Indefinite 400000 Indefinite false 0 0 0 100000 true false Square Care Provider Holdings, LLC Simon Prince Dr. Simon Prince Chief Executive Officer 2016-07-12