0001686754-16-000001.txt : 20161007 0001686754-16-000001.hdr.sgml : 20161007 20161007153521 ACCESSION NUMBER: 0001686754-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161007 DATE AS OF CHANGE: 20161007 EFFECTIVENESS DATE: 20161007 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Provision Healthcare, LLC CENTRAL INDEX KEY: 0001686754 IRS NUMBER: 203345671 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-272078 FILM NUMBER: 161927621 BUSINESS ADDRESS: STREET 1: 1400 DOWELL SPRINGS BOULEVARD STREET 2: SUITE 350 CITY: KNOXVILLE STATE: TN ZIP: 37909 BUSINESS PHONE: 8656842616 MAIL ADDRESS: STREET 1: 1400 DOWELL SPRINGS BOULEVARD STREET 2: SUITE 350 CITY: KNOXVILLE STATE: TN ZIP: 37909 D 1 primary_doc.xml X0707 D LIVE 0001686754 Provision Healthcare, LLC 1400 DOWELL SPRINGS BOULEVARD SUITE 350 KNOXVILLE TN TENNESSEE 37909 8656842616 TENNESSEE None None Limited Liability Company true Terry Douglass 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Executive Officer Director Mary Lou DuBois 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Director Joseph Matteo 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Director James Blankemeyer 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Director Tracy Dobbs 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Director Christopher Brown 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Executive Officer Michael Sommi 1400 Dowell Springs Blvd. Suite 350 Knoxville TN TENNESSEE 37909 Executive Officer Other Health Care Decline to Disclose 06b false 2016-08-04 false true false 0 None None None None n/a n/a TN TENNESSEE 37909 TX TEXAS true Indefinite 30350000 Indefinite The offering closed as of August 29, 2016. false 6 0 0 0 false Provision Healthcare, LLC CFA Charles Aiken Assoc. General Counsel 2016-10-07