0001080368-22-000001.txt : 20220106 0001080368-22-000001.hdr.sgml : 20220106 20220106161348 ACCESSION NUMBER: 0001080368-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220106 DATE AS OF CHANGE: 20220106 EFFECTIVENESS DATE: 20220106 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Plant Based TeleHealth, Inc. CENTRAL INDEX KEY: 0001902710 IRS NUMBER: 844228285 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-428210 FILM NUMBER: 22514967 BUSINESS ADDRESS: STREET 1: 1716 MAIN STREET STREET 2: SUITE 163 CITY: LONGMONT STATE: CO ZIP: 80501 BUSINESS PHONE: 888-420-7284 MAIL ADDRESS: STREET 1: 1716 MAIN STREET STREET 2: SUITE 163 CITY: LONGMONT STATE: CO ZIP: 80501 D 1 primary_doc.xml X0708 D LIVE 0001902710 Plant Based TeleHealth, Inc. 1716 MAIN STREET SUITE 163 LONGMONT CO COLORADO 80501 888-420-7284 DELAWARE None None Corporation true 2021 Anthony Masiello 1716 MAIN STREET Suite 163 LONGMONT CO COLORADO 80501 Executive Officer Director Director, President, CEO, and Secretary Laurie Marbas, MD 1716 MAIN STREET Suite 163 LONGMONT CO COLORADO 80501 Director Shaleen Shah 1716 MAIN STREET Suite 163 LONGMONT CO COLORADO 80501 Director Other Health Care Decline to Disclose 06b false 2021-12-17 false true false 19998 749999 749999 0 false 7 0 0 0 false Plant Based TeleHealth, Inc. /Anthony Masiello/ Anthony Masiello President and CEO 2022-01-05