| LCA CASE NUMBER | I-200-21062-116762 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-03 |
| DECISION DATE | 2021-03-10 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physical Therapist |
| SOC CODE | 29-1123.00 |
| SOC TITLE | Physical Therapists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-03-08 |
| END DATE | 2024-03-07 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Ensign Montgomery, LLC |
| TRADE NAME DBA | Park View Post Acute |
| EMPLOYER ADDRESS1 | 3751 Montgomery Drive |
| EMPLOYER CITY | Santa Rosa |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95405 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19494879500 |
| NAICS CODE | 623110 |
| EMPLOYER POC LAST NAME | Burnam |
| EMPLOYER POC FIRST NAME | Soon |
| EMPLOYER POC JOB TITLE | Treasurer |
| EMPLOYER POC ADDRESS 1 | 29222 Rancho Viejo Rd |
| EMPLOYER POC ADDRESS 2 | Suite 127 |
| EMPLOYER POC CITY | SAN JUAN CAPISTRANO |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 92691 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19494879500 |
| EMPLOYER POC EMAIL | cpodesta@ensignservices.net |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Ford |
| AGENT ATTORNEY FIRST NAME | Richard |
| AGENT ATTORNEY MIDDLE NAME | A |
| AGENT ATTORNEY ADDRESS1 | 616 South Boston Ave., |
| AGENT ATTORNEY ADDRESS2 | Ste. 300 |
| AGENT ATTORNEY CITY | Tulsa |
| AGENT ATTORNEY STATE | OK |
| AGENT ATTORNEY POSTAL CODE | 74119 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19183923440 |
| AGENT ATTORNEY EMAIL ADDRESS | raf@ford-lawfirm.com |
|
| LAWFIRM NAME BUSINESS NAME | Ford Law Firm, PLLC |
| STATE OF HIGHEST COURT | OK |
| NAME OF HIGHEST STATE COURT | Supreme Court of Oklahoma |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 3751 Montgomery Drive |
| LCA CASE WORKLOC1 CITY | Santa Rosa |
| WORKSITE COUNTY | SONOMA |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 95405 |
| LCA CASE WAGE RATE FROM | 49 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 49 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | III |
| 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 |
| PREPARER LAST NAME | Kaltenbach |
| PREPARER FIRST NAME | Adam |
| PREPARER MIDDLE INITIAL | K |
| PREPARER BUSINESS NAME | Ford Law Firm, PLLC |
| PREPARER EMAIL | akk@ford-lawfirm.com |
