# FAIRLIFE HEALTHCARE, LLC

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

## Provider details

- **NPI number:** 1801384979
- **Authorized official:** KOFI KLU (DIRECTOR OF NURSING / CEO)
- **Authorized official phone:** (301) 326-6103

## Contact information

- **Practice address:** 2288 BLUE WATER BLVD STE 330, ODENTON, MD 21113-3311
- **Practice address phone:** (443) 300-7158
- **Mailing address:** 2288 BLUE WATER BLVD STE 330, ODENTON, MD 21113-3311
- **Mailing address phone:** (443) 300-7158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | R4141 | MD | Yes |

## Other

- **Enumeration date:** 04/24/2018
- **Last updated:** 04/07/2026