MEDICARE: PETITE FLEUR NURSING CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1649138074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETITE FLEUR NURSING CENTER LLC

Provider Business Mailing Address
First Line	:	14 MAIN ST
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-2307
Country	:	US
Telephone Number	:	631-987-2912
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 MAIN ST
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-2307
Country	:	US
Telephone Number	:	631-987-2912
Fax Number	:

Authorized Official
Title or Position	:	CEO-MEMBER
Name	:	MICHAEL BARTOLOTTA
Credential	:
Telephone Number	:	631-987-2912

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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