| LCA CASE NUMBER | I-200-21019-021214 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-19 |
| DECISION DATE | 2021-01-26 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-03-15 |
| END DATE | 2024-03-14 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Keystone Rural Health Consortia, Inc. |
| EMPLOYER ADDRESS1 | 90 East 2nd Street |
| EMPLOYER CITY | Emporium |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 15834 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18142452119 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Bennardi |
| EMPLOYER POC FIRST NAME | Kristie |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 90 East 2nd Street |
| EMPLOYER POC CITY | Emporium |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 15834 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18142452119 |
| EMPLOYER POC EMAIL | kriben@keystoneruralhealth.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Castrodale |
| AGENT ATTORNEY FIRST NAME | Alexander |
| AGENT ATTORNEY MIDDLE NAME | R. |
| AGENT ATTORNEY ADDRESS1 | 625 Liberty Ave |
| AGENT ATTORNEY ADDRESS2 | 5th Floor |
| AGENT ATTORNEY CITY | PITTSBURGH |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 15222 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14122974712 |
| AGENT ATTORNEY EMAIL ADDRESS | alex.castrodale@dentons.com |
| LAWFIRM NAME BUSINESS NAME | Dentons Cohen and Grigsby PC |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Pennsylvania Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 81 Clarion Road |
| LCA CASE WORKLOC1 CITY | Johnsonburg |
| WORKSITE COUNTY | ELK |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 15845 |
| LCA CASE WAGE RATE FROM | 175000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 141398 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
