| LCA CASE NUMBER | I-200-19337-175698 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-12-02 |
| DECISION DATE | 2019-12-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physical Therapist |
| SOC CODE | 29-1123.00 |
| SOC TITLE | Physical Therapists |
| FULL TIME POSITION | N |
| LCA CASE EMPLOYMENT START DATE | 2020-06-01 |
| END DATE | 2023-05-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Mt. Vernon Operations, LLC |
| TRADE NAME DBA | Life Care Center of Mount Vernon |
| EMPLOYER ADDRESS1 | 2120 East Division Street |
| EMPLOYER CITY | Mount Vernon |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98273 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | +13604244258 |
| NAICS CODE | 62311 |
| EMPLOYER POC LAST NAME | Nichols |
| EMPLOYER POC FIRST NAME | Paul |
| EMPLOYER POC JOB TITLE | Director of Rehabilitation |
| EMPLOYER POC ADDRESS1 | 2120 East Division Street |
| EMPLOYER POC CITY | Mount Vernon |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98273 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | +13604244258 |
| EMPLOYER POC EMAIL | paul_nichols@LCCA.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Hom |
| AGENT ATTORNEY FIRST NAME | Harold |
| AGENT ATTORNEY MIDDLE NAME | Lee |
| AGENT ATTORNEY ADDRESS1 | 30200 Detroit Road |
| AGENT ATTORNEY ADDRESS2 | Suite D |
| AGENT ATTORNEY CITY | Westlake |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 44145 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14402500400.0 |
| AGENT ATTORNEY EMAIL ADDRESS | harold@homlaw.net |
| LAWFIRM NAME BUSINESS NAME | Harold L. Hom Co., LPA |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | Life Care Center of Mount Vernon |
| WORKSITE ADDRESS2 | 2120 East Division Street |
| LCA CASE WORKLOC1 CITY | Mount Vernon |
| WORKSITE COUNTY | SKAGIT |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98273 |
| LCA CASE WAGE RATE FROM | 41.0 |
| LCA CASE WAGE RATE TO | 50.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 40.93 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hom |
| PREPARER FIRST NAME | Harold |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Harold L. Hom Co., LPA |
| PREPARER EMAIL | harold@homlaw.net |
