0001140361-17-032224.txt : 20170815 0001140361-17-032224.hdr.sgml : 20170815 20170815123622 ACCESSION NUMBER: 0001140361-17-032224 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170815 DATE AS OF CHANGE: 20170815 EFFECTIVENESS DATE: 20170815 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ELLIPSIS FISHERS MEMORY CARE, LLC CENTRAL INDEX KEY: 0001714750 IRS NUMBER: 822178727 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-292819 FILM NUMBER: 171033097 BUSINESS ADDRESS: STREET 1: 1 S. RANGELINE RD, SUITE 310 CITY: CARMEL STATE: IN ZIP: 46032 BUSINESS PHONE: (765) 702-3025 MAIL ADDRESS: STREET 1: 1 S. RANGELINE RD, SUITE 310 CITY: CARMEL STATE: IN ZIP: 46032 D 1 primary_doc.xml X0708 D LIVE 0001714750 ELLIPSIS FISHERS MEMORY CARE, LLC 1 S. RANGELINE RD, SUITE 310 CARMEL IN INDIANA 46032 (765) 702-3025 INDIANA None None Limited Liability Company true 2017 ADLAI CHESTER 1 S. RANGELINE RD, SUITE 310 CARMEL IN INDIANA 46032 Executive Officer CEO VINCENT EDWARD GROGG 1 S. RANGELINE RD STE 310 CARMEL IN INDIANA 46032 Executive Officer CHAIRMAN KYLE JARRETT 1 S. RANGELINE RD STE 310 CARMEL IN INDIANA 46032 Executive Officer SVP MIKE MATTIS 1 S. RANGELINE RD STE 310 CARMEL IN INDIANA 46032 Executive Officer SVP DOUG PEDERSEN 1 S. RANGELINE RD STE 310 CARMEL IN INDIANA 46032 Executive Officer SVP Other Health Care Decline to Disclose 06b false 2017-08-10 false true false 50000 1700000 1610000 90000 false 15 0 0 0 false ELLIPSIS FISHERS MEMORY CARE, LLC ADLAI CHESTER ADLAI CHESTER ceo 2017-08-15