0000899243-19-003449.txt : 20190213 0000899243-19-003449.hdr.sgml : 20190213 20190213170426 ACCESSION NUMBER: 0000899243-19-003449 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181231 FILED AS OF DATE: 20190213 DATE AS OF CHANGE: 20190213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBS JOEY A CENTRAL INDEX KEY: 0001243878 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35331 FILM NUMBER: 19598463 MAIL ADDRESS: STREET 1: 830 CRESCENT CENTER DRIVE STREET 2: SUITE 610 CITY: FRANKLIN STATE: TN ZIP: 37067 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acadia Healthcare Company, Inc. CENTRAL INDEX KEY: 0001520697 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6100 TOWER CIRCLE STREET 2: SUITE 1000 CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: 615-861-6000 MAIL ADDRESS: STREET 1: 6100 TOWER CIRCLE STREET 2: SUITE 1000 CITY: FRANKLIN STATE: TN ZIP: 37067 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2018-12-31 0 0 1 0001520697 Acadia Healthcare Company, Inc. ACHC 0001243878 JACOBS JOEY A ACADIA HEALTHCARE COMPANY, INC. 6100 TOWER CIRCLE, SUITE 1000 FRANKLIN TN 37067 1 0 0 0 Common Stock 2018-12-16 4 F 0 36126 28.93 D 248073 D Common Stock 267649 I See Footnote Mr. Jacobs expressly disclaims beneficial ownership of the reported securities, except to the extent of his pecuniary interest therein. By the Jeremy Brent Jacobs GST Non-Exempt u/a/d 04/26/2011 and Scott Douglas Jacobs GST Non-Exempt Trust u/a/d 04/26/2011. /s/ Christopher L. Howard as Attorney in Fact for Joey A. Jacobs 2019-02-13