| CASE NUMBER | I-200-23300-462203 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/27/2023 |
| DECISION DATE | 11/3/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Surgical Nurse |
| SOC CODE | 29-1141.04 |
| SOC TITLE | Clinical Nurse Specialists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/4/2024 |
| END DATE | 1/3/2027 |
| TOTAL WORKER POSITIONS | 4 |
| NEW EMPLOYMENT | 4 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Lifeline Nursing Solutions, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1415 Hawcreek Circle |
| EMPLOYER ADDRESS2 | Unit 202 |
| EMPLOYER CITY | Cumming |
| EMPLOYER STATE | GA |
| EMPLOYER POSTAL CODE | 30041 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 14045459878 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 5613 |
| EMPLOYER POC LAST NAME | Katikaneni |
| EMPLOYER POC FIRST NAME | Raghu |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 1415 Hawcreek Circle |
| EMPLOYER POC ADDRESS2 | Unit 202 |
| EMPLOYER POC CITY | Cumming |
| EMPLOYER POC STATE | GA |
| EMPLOYER POC POSTAL CODE | 30041 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 14045459878 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | raghu@lifelinenursingsolutions.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Chary |
| AGENT ATTORNEY FIRST NAME | Siddharth |
| AGENT ATTORNEY MIDDLE NAME | S |
| AGENT ATTORNEY ADDRESS1 | 1123 Broadway |
| AGENT ATTORNEY ADDRESS2 | Suite 1210 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10010 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12129608365 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | sid@charylaw.com |
| LAWFIRM NAME BUSINESS NAME | Chary Law |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 4 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Knapp Medical Center |
| WORKSITE ADDRESS1 | 1401 E 8th St. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Welasco |
| WORKSITE COUNTY | HIDALGO |
| WORKSITE STATE | TX |
| WORKSITE POSTAL CODE | 78596 |
| WAGE RATE OF PAY FROM | 68600 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $66,560.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| 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 | 2024-04-01 |
