| CASE NUMBER | I-200-24355-561179 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/20/2024 |
| DECISION DATE | 12/31/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Qualified Mental Health Professional |
| SOC CODE | 21-1014.00 |
| SOC TITLE | Mental Health Counselors |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/6/2025 |
| END DATE | 1/5/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Sky Lakes Medical Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 2865 Daggett Avenue |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Klamath Falls |
| EMPLOYER STATE | OR |
| EMPLOYER POSTAL CODE | 97601 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15412746150 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | French |
| EMPLOYER POC FIRST NAME | Jonathan |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Vice President and General Counsel |
| EMPLOYER POC ADDRESS1 | 2865 Daggett Avenue |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Klamath Falls |
| EMPLOYER POC STATE | OR |
| EMPLOYER POC POSTAL CODE | 97601 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15412746150 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | jonathan.french@skylakes.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Brown |
| AGENT ATTORNEY FIRST NAME | Thomas |
| AGENT ATTORNEY MIDDLE NAME | STEPHEN |
| AGENT ATTORNEY ADDRESS1 | 2139 BROAD STREET |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | CRANSTON |
| AGENT ATTORNEY STATE | RI |
| AGENT ATTORNEY POSTAL CODE | 2905 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14012744040 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | TBROWN@RODIOBROWN.COM |
| LAWFIRM NAME BUSINESS NAME | Rodio & Brown, Ltd. |
| STATE OF HIGHEST COURT | RI |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2821 Daggett Avenue |
| WORKSITE ADDRESS2 | Suite 200 |
| WORKSITE CITY | Klamath Falls |
| WORKSITE COUNTY | KLAMATH |
| WORKSITE STATE | OR |
| WORKSITE POSTAL CODE | 97601 |
| WAGE RATE OF PAY FROM | $30.50 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $45.33 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $26.02 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 | 2025-01-06 |
