| CASE NUMBER | I-200-24054-742662 |
| CASE STATUS | Certified |
| RECEIVED DATE | 2/23/2024 |
| DECISION DATE | 3/1/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Mental Health Program Manager |
| SOC CODE | 11-9151.00 |
| SOC TITLE | Social and Community Service Managers |
| FULL TIME POSITION | N |
| BEGIN DATE | 3/4/2024 |
| END DATE | 10/2/2025 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Northern Indiana Hispanic Health Coalition INC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 444 North Nappanee Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Elkhart |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46514 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15745220966 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621330 |
| EMPLOYER POC LAST NAME | Quintero |
| EMPLOYER POC FIRST NAME | Liliana |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Executive Director |
| EMPLOYER POC ADDRESS1 | 444 North Nappanee Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Elkhart |
| EMPLOYER POC STATE | IN |
| EMPLOYER POC POSTAL CODE | 46514 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15745220966 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | lquintero@nihhc.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Marques |
| AGENT ATTORNEY FIRST NAME | Ryan |
| AGENT ATTORNEY MIDDLE NAME | C. |
| AGENT ATTORNEY ADDRESS1 | 1 American Sq. |
| AGENT ATTORNEY ADDRESS2 | Suite 2500 |
| AGENT ATTORNEY CITY | Indianapolis |
| AGENT ATTORNEY STATE | IN |
| AGENT ATTORNEY POSTAL CODE | 46282 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13176391210 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | rmarques@lewis-kappes.com |
| LAWFIRM NAME BUSINESS NAME | Lewis & Kappes, PC |
| STATE OF HIGHEST COURT | IN |
| NAME OF HIGHEST STATE COURT | Indiana Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 444 North Nappanee Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Elkhart |
| WORKSITE COUNTY | ELKHART |
| WORKSITE STATE | IN |
| WORKSITE POSTAL CODE | 46514 |
| WAGE RATE OF PAY FROM | 28 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $22.92 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-04-03 |
