# MARC BONAGUIDE LLC

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

## Provider details

- **NPI number:** 1487176145
- **Authorized official:** MARC BONAGUIDE LCSW (MANAGER)
- **Authorized official phone:** (860) 951-1240

## Contact information

- **Practice address:** 50 ALBANY TPKE, CANTON, CT 06019-2516
- **Practice address phone:** (860) 951-1240
- **Mailing address:** 10 SUNRISE TER, WEATOGUE, CT 06089-9755

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/13/2017
- **Last updated:** 07/13/2017