Fairlife Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

R4141 Issued in MD

Legal business name

FAIRLIFE HEALTHCARE, LLC

Practice address

2288 Blue Water Blvd Ste 330
Odenton, MD 21113-3311

Phone

(443) 300-7158

NPI assigned

Apr 24, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kofi Klu

Title

Director of Nursing / Ceo

Phone

(301) 326-6103

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1801384979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2288 BLUE WATER BLVD STE 330",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211133311",
            "telephone_number": "443-300-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 BLUE WATER BLVD STE 330",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211133311",
            "telephone_number": "443-300-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRLIFE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "KLU",
        "authorized_official_first_name": "KOFI",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING / CEO",
        "authorized_official_telephone_number": "301-326-6103"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R4141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5224014900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Ennis
• Ufuoma Splendour Eriekpare
• Hope Evans
• Daniel Ezidiegwu Jr.
• Savannah Fabius
• Fairlife Support Solutions, Inc.
• Olubukola Fakunle, PHARM.D
• Oluwateniola Faleti, BT
• Kelley Elizabeth Farwell, MSED, ATC, CSCS
• Bethanie Anne Faulkner, CDL

• Home Health Agency in Odenton, MD
• Providers in Odenton, MD by specialty
• Home Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.