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Organization

FAIRLIFE HEALTHCARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KOFI KLU (DIRECTOR OF NURSING / CEO)
(301) 326-6103
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R4141
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5224014900
MD
Enumeration date
04/24/2018
Last updated
04/07/2026
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