0001726601-21-000001.txt : 20210330 0001726601-21-000001.hdr.sgml : 20210330 20210330110707 ACCESSION NUMBER: 0001726601-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210330 DATE AS OF CHANGE: 20210330 EFFECTIVENESS DATE: 20210330 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Cityblock Health, Inc. CENTRAL INDEX KEY: 0001726601 IRS NUMBER: 822839581 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-393977 FILM NUMBER: 21784378 BUSINESS ADDRESS: STREET 1: 55 WASHINGTON STREET STREET 2: SUITE 552 CITY: NEW YORK STATE: NY ZIP: 11201 BUSINESS PHONE: 000-000-0000 MAIL ADDRESS: STREET 1: 55 WASHINGTON STREET STREET 2: SUITE 552 CITY: NEW YORK STATE: NY ZIP: 11201 D 1 primary_doc.xml X0708 D LIVE 0001726601 Cityblock Health, Inc. 55 Water Street SUITE 4C Brooklyn NY NEW YORK 11201 000-000-0000 DELAWARE None None Corporation true 2017 Iyah Romm c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Executive Officer Director Daniel Doctoroff c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Ambar Bhattacharyya c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Elliot Geidt c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Chris Bischoff c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Toyin Ajayi c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Wendy Chow c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Executive Officer Andrea Blankmeyer c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Executive Officer Hemant Taneja c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Jennifer Schneider c/o Cityblock Health, Inc. 55 Water Street, Suite 4C Brooklyn NY NEW YORK 11201 Director Other Technology Decline to Disclose 06b false 2021-03-15 false true false 0 192250020 183250011 9000009 false 19 0 0 0 false Cityblock Health, Inc. /s/ Iyah Romm Iyah Romm Chief Executive Officer 2021-03-30