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General NPI Number Information
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NPI Number | 1629811310
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Entity Type | Organization
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Legal Business Name | VIDA COLLECTIVE, LLC
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Dates
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Enumeration Date | 06/18/2024
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 420 E 21ST ST STE G
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City | LITTLE ROCK
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State | AR
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Zip | 72206-2350
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Country | US
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Telephone | 501-300-7456
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Fax | 501-600-4811
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Provider Business Mailing Address
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Address Line | 420 E 21ST ST STE G
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City | LITTLE ROCK
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State | AR
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Zip | 72206-2350
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Country | US
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Telephone | 501-300-7456
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Fax | 501-600-4811
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Authorized Official
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Title or Position | OWNER
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Name | ANA R ELDRIDGE
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Credential | LPC
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Telephone | 501-300-7456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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