0001987085-23-000001.txt : 20230726 0001987085-23-000001.hdr.sgml : 20230726 20230726161038 ACCESSION NUMBER: 0001987085-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230726 DATE AS OF CHANGE: 20230726 EFFECTIVENESS DATE: 20230726 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Mentavi, Inc. CENTRAL INDEX KEY: 0001987085 IRS NUMBER: 931549123 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-487978 FILM NUMBER: 231113713 BUSINESS ADDRESS: STREET 1: 625 KENMOOR AVE. SE STREET 2: SUITE 301 CITY: GRAND RAPIDS STATE: MI ZIP: 49546 BUSINESS PHONE: 888-493-2343 MAIL ADDRESS: STREET 1: 625 KENMOOR AVE. SE STREET 2: SUITE 301 CITY: GRAND RAPIDS STATE: MI ZIP: 49546 D 1 primary_doc.xml X0708 D LIVE 0001987085 Mentavi, Inc. 625 KENMOOR AVE. SE SUITE 301 GRAND RAPIDS MI MICHIGAN 49546 888-493-2343 DELAWARE ADHD Diagnosis Online, PLLC Patient Education Resources, LLC ADHD Online, LLC None Corporation true 2023 Keith Brophy 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Executive Officer Timothy Gutwald 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Executive Officer Dave Peralta 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Executive Officer Barry Herman 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Executive Officer Dale Grogan 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Director Randall Duthler 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Director Zachariah Booker 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Director Joseph Lampen 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Director Kristine White 625 Kenmoor Ave. SE Suite 301 Grand Rapids MI MICHIGAN 49546 Director Other Technology Decline to Disclose 06b false 2023-05-09 false true false 0 3000000 2073975 926025 Excludes conversion of outstanding convertible notes into the equity issued in this offering. false 5 0 0 500000 $500,000 of the gross proceeds were used to repurchase common stock from a director and former executive officer. false Mentavi, Inc. /s/ Timothy Gutwald Timothy Gutwald Secretary and General Counsel 2023-07-26