0001771582-19-000001.txt : 20190502 0001771582-19-000001.hdr.sgml : 20190502 20190501173323 ACCESSION NUMBER: 0001771582-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190502 DATE AS OF CHANGE: 20190501 EFFECTIVENESS DATE: 20190502 FILER: COMPANY DATA: COMPANY CONFORMED NAME: COMMUNITY BASED CARE, LLC CENTRAL INDEX KEY: 0001771582 IRS NUMBER: 474471803 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-338615 FILM NUMBER: 19788887 BUSINESS ADDRESS: STREET 1: 3210 FAIRHILL DRIVE, SUITE 100 CITY: RALEIGH STATE: NC ZIP: 27612 BUSINESS PHONE: 919-256-0824 MAIL ADDRESS: STREET 1: 3210 FAIRHILL DRIVE, SUITE 100 CITY: RALEIGH STATE: NC ZIP: 27612 D 1 primary_doc.xml X0708 D LIVE 0001771582 COMMUNITY BASED CARE, LLC 3210 FAIRHILL DRIVE, SUITE 100 RALEIGH NC NORTH CAROLINA 27612 919-256-0824 DELAWARE None None Limited Liability Company true 2015 DAVID WITTELS 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Director MICHAEL SOMMA 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Director EUGENE RODGERS 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Executive Officer Director JEFFREY WINTER 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Director LANIER CANSLER 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Director DEREK IRWIN 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Director MICHAEL KOTZEN 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Executive Officer Director LAURIE MCDANIEL 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Executive Officer RICHARD EDWARDS 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Executive Officer LAURA FORTIER 3210 FAIRHILL DRIVE SUITE 100 RALEIGH NC NORTH CAROLINA 27612 Executive Officer Other Health Care Decline to Disclose 06b false 2019-04-24 true true false 0 15000000 7500000 7500000 false 3 0 0 0 false COMMUNITY BASED CARE, LLC /s/ Victor DeMarco Victor DeMarco Attorney-in-Fact 2019-05-01