0001726601-21-000002.txt : 20210903 0001726601-21-000002.hdr.sgml : 20210903 20210903163809 ACCESSION NUMBER: 0001726601-21-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210903 DATE AS OF CHANGE: 20210903 EFFECTIVENESS DATE: 20210903 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: 021-412432 FILM NUMBER: 211237045 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. 495 Flatbush Avenue B9 Brooklyn NY NEW YORK 11225 000-000-0000 DELAWARE None None Corporation true 2017 Iyah Romm c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Executive Officer Director Daniel Doctoroff c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Ambar Bhattacharyya c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Andy Slavitt c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Chris Bischoff c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Toyin Ajayi c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Wendy Chow c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Executive Officer Andrea Blankmeyer c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Executive Officer Nagraj Kashyap c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Jennifer Schneider c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Yvette Bright c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Susan Brown c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Executive Officer Deval Patrick c/o Cityblock Health, Inc. 495 Flatbush Avenue, B9 Brooklyn NY NEW YORK 11225 Director Other Technology Decline to Disclose 06b false 2021-09-03 false true false 0 399999254 374029257 25969997 false 14 0 0 0 false Cityblock Health, Inc. /s/ Iyah Romm Iyah Romm Chief Executive Officer 2021-09-03