Organization
ELTY MINDS & RESEARCH SOLUTIONS GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BANTALE AYISIRE (CEO)
(323) 412-9966
Entity
Organization
Contact information
Practice address
20623 GREEN ASH LN, WINNETKA, CA 91306-1557
(323) 412-9966
(818) 303-3331
Mailing address
20623 GREEN ASH LN, WINNETKA, CA 91306-1557
(323) 412-9966
(818) 303-3331
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
03/25/2026
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