# SOURCE HOLDINGS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194374603
- **Authorized official:** MS. GINA DECESARE MS,OTR/L (OWNER/SOLE PROPRIETOR)
- **Authorized official phone:** (914) 263-1713

## Contact information

- **Practice address:** 466 MAIN ST, NEW ROCHELLE, NY 10801-6431
- **Practice address phone:** (718) 769-2698
- **Mailing address:** 13 BRYANT CRES APT 1L, WHITE PLAINS, NY 10605-2711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/06/2019
- **Last updated:** 09/06/2019