| LCA CASE NUMBER | I-200-20232-776795 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-08-19 |
| DECISION DATE | 2020-08-26 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Certified Registered Nurse Anesthetist |
| SOC CODE | 29-1151.00 |
| SOC TITLE | Nurse Anesthetists |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-08-20 |
| END DATE | 2022-06-30 |
| 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 | NorthStar Anesthesia of Michigan III, PLLC |
| EMPLOYER ADDRESS1 | 6225 N. State Highway, 161 |
| EMPLOYER ADDRESS2 | SUITE 200 |
| EMPLOYER CITY | Irving |
| EMPLOYER STATE | TX |
| EMPLOYER POSTAL CODE | 75038 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12146870684 |
| NAICS CODE | 541690 |
| EMPLOYER POC LAST NAME | Stubblefield |
| EMPLOYER POC FIRST NAME | Amanda |
| EMPLOYER POC JOB TITLE | Human Resources Generalist |
| EMPLOYER POC ADDRESS1 | 6225 North State Highway 161 |
| EMPLOYER POC ADDRESS2 | SUITE 200 |
| EMPLOYER POC CITY | Irving |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 75038 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12146870684 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Sewell |
| AGENT ATTORNEY FIRST NAME | Keely |
| AGENT ATTORNEY ADDRESS1 | 1403 Ellis Ave |
| AGENT ATTORNEY CITY | Fort Worth |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 76164 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18177336187.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Law Office of Jason Mills, PLLC |
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Texas Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | Beaumont Hospital Taylor, 10000 Telegraph Road |
| LCA CASE WORKLOC1 CITY | Taylor |
| WORKSITE COUNTY | WAYNE |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 48180 |
| LCA CASE WAGE RATE FROM | 91.5 |
| LCA CASE WAGE RATE TO | 93.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 82.12 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Employment |
