0001744101-23-000002.txt : 20230113 0001744101-23-000002.hdr.sgml : 20230113 20230113134919 ACCESSION NUMBER: 0001744101-23-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230113 DATE AS OF CHANGE: 20230113 EFFECTIVENESS DATE: 20230113 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ModifyHealth, Inc. CENTRAL INDEX KEY: 0001744101 IRS NUMBER: 824839509 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-470701 FILM NUMBER: 23528290 BUSINESS ADDRESS: STREET 1: 190 BLUEGRASS VALLEY PARKWAY CITY: ALPHARETTA STATE: GA ZIP: 30005 BUSINESS PHONE: 7705195503 MAIL ADDRESS: STREET 1: 190 BLUEGRASS VALLEY PARKWAY CITY: ALPHARETTA STATE: GA ZIP: 30005 FORMER COMPANY: FORMER CONFORMED NAME: Modify Health LLC DATE OF NAME CHANGE: 20180620 D 1 primary_doc.xml X0708 D LIVE 0001744101 ModifyHealth, Inc. 190 BLUEGRASS VALLEY PARKWAY ALPHARETTA GA GEORGIA 30005 (888) 766-3439 DELAWARE Modify Health LLC Corporation true 2022 George B Pratt 190 Bluegrass Valley Parkway Alpharetta GA GEORGIA 30005 Executive Officer Director Chase Perry 190 Bluegrass Valley Parkway Alpharetta GA GEORGIA 30005 Director Ben Leedle 190 Bluegrass Valley Parkway Alpharetta GA GEORGIA 30005 Director Rik Vandevenne 190 Bluegrass Valley Parkway Alpharetta GA GEORGIA 30005 Director Other Health Care Decline to Disclose 06b false 2022-12-30 false true false 0 14000000 10000000 4000000 false 5 0 0 0 false ModifyHealth, Inc. George B. Pratt George B. Pratt by James B. Young attorney-in-fact CEO 2023-01-13