| LCA CASE NUMBER | I-200-21113-252216 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-22 |
| DECISION DATE | 2021-04-29 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-13 |
| END DATE | 2024-08-12 |
| 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 | Outreach Professional Services, Inc. |
| TRADE NAME DBA | St. Vincent Medical Group |
| EMPLOYER ADDRESS1 | 2475 East 22nd Street |
| EMPLOYER CITY | Cleveland |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 44115 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12162416466 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Jerse |
| EMPLOYER POC FIRST NAME | Shannon |
| EMPLOYER POC MIDDLE NAME | Fogarty |
| EMPLOYER POC JOB TITLE | General Counsel |
| EMPLOYER POC ADDRESS 1 | 2475 East 22nd Street |
| EMPLOYER POC CITY | Cleveland |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 44115 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12162416466 |
| EMPLOYER POC EMAIL | shannon.jerse@stvincentcharity.com |
| AGENT REPRESENTING EMPLOYER | True |
| 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 |
| 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 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | St. Vincent Charity Medical Ctr - Health Care Clinic |
| WORKSITE ADDRESS2 | 2351 East 22nd Street |
| LCA CASE WORKLOC1 CITY | Cleveland |
| WORKSITE COUNTY | CUYAHOGA |
| LCA CASE WORKLOC1 STATE | OH |
| WORKSITE POSTAL CODE | 44115 |
| LCA CASE WAGE RATE FROM | 210000 |
| LCA CASE WAGE RATE TO | 230000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 162698 |
| PW UNIT OF PAY | Year |
| 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 | Hom |
| PREPARER FIRST NAME | Harold |
| PREPARER MIDDLE INITIAL | Lee |
| PREPARER BUSINESS NAME | Harold L. Hom Co., LPA |
| PREPARER EMAIL | harold@homlaw.net |
