0001973419-26-000002.txt : 20260611
0001973419-26-000002.hdr.sgml : 20260611
20260611104142
ACCESSION NUMBER: 0001973419-26-000002
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: Rule 506(b) provides a "safer harbor" for a private offering
FILED AS OF DATE: 20260611
DATE AS OF CHANGE: 20260611
EFFECTIVENESS DATE: 20260611
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: 1104Health, Inc.
CENTRAL INDEX KEY: 0001973419
ORGANIZATION NAME:
EIN: 861432645
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-586999
FILM NUMBER: 261081785
BUSINESS ADDRESS:
STREET 1: 5110 MANNING DRIVE
CITY: BETHESDA
STATE: MD
ZIP: 20814
BUSINESS PHONE: 800-881-6113
MAIL ADDRESS:
STREET 1: 5110 MANNING DRIVE
CITY: BETHESDA
STATE: MD
ZIP: 20814
D
1
primary_doc.xml
X0708
D
LIVE
0001973419
1104Health, Inc.
5110 MANNING DRIVE
BETHESDA
MD
MARYLAND
20814
800-881-6113
DELAWARE
1104Health, LLC
None
Corporation
true
Qun
Rose
Wang
5110 Manning Drive
Bethesda
MD
MARYLAND
20814
Executive Officer
Director
Other Technology
Decline to Disclose
- 06b
false
true
false
true
true
true
true
Simple Agreement for Future Equity (SAFE)
false
0
Indefinite
0
Indefinite
false
0
0
0
0
false
1104Health, Inc.
/S/ QUN ROSE WANG
Qun Rose Wang
Chief Executive Officer
2026-06-11