for eg

.gitignore

tmp/**

Gemfile

# frozen_string_literal: true
source "https://rubygems.org"

gem 'nokogiri'
gem 'open-uri-cached'
gem 'activesupport'

Gemfile.lock

GEM
  remote: https://rubygems.org/
  specs:
    activesupport (5.1.4)
      concurrent-ruby (~> 1.0, >= 1.0.2)
      i18n (~> 0.7)
      minitest (~> 5.1)
      tzinfo (~> 1.1)
    concurrent-ruby (1.0.5)
    i18n (0.9.0)
      concurrent-ruby (~> 1.0)
    mini_portile2 (2.3.0)
    minitest (5.10.3)
    nokogiri (1.8.1)
      mini_portile2 (~> 2.3.0)
    open-uri-cached (0.0.5)
    thread_safe (0.3.6)
    tzinfo (1.2.3)
      thread_safe (~> 0.1)

PLATFORMS
  ruby

DEPENDENCIES
  activesupport
  nokogiri
  open-uri-cached

BUNDLED WITH
   1.14.3

globaldownsyndrome.org.rb

require 'rubygems'
require 'bundler/setup'
require 'nokogiri'
require 'open-uri/cached'
require 'fileutils'
OpenURI::Cache.cache_path = "#{File.dirname(__FILE__)}/tmp/cache"
FileUtils.mkdir_p OpenURI::Cache.cache_path
require 'active_support/core_ext/string'
require 'csv'


def fetch_doc(url)
  if !OpenURI::Cache.get(url)
    sleep(0.1) # dont hammer our server
  end
  Nokogiri::HTML(open(url))
end

rest_period = 1 #second
index_url = 'https://www.globaldownsyndrome.org/research-medical-care/medical-care-providers/'
index_doc = fetch_doc(index_url)

records = []
index_doc.css('a[href^="/research-medical-care/medical-care-providers/"]').each do |node|
  state_url = URI.join(index_url, node['href']).to_s
  state_doc = fetch_doc(state_url)
  warn "Processing #{state_url}"
  #FIXME: there isnt a great way to find this
  state_doc.css('#content table h2').each do |title|
    table = title.ancestors('table').first
    id = table['id']
    data = {
      source_url: state_url,
      globaldownsyndrome_org_url: ("#{state_url}##{id}" if id),
      title: title.text
    }
    table.css('tr').each do |tr|
      label = tr.at_css('td').text.strip
      # real labels look like foo: or foo?
      if label =~ /[?:]\z/
        label = label.gsub /[?:]\z/, ''
        # services provide works like a section header
        value = if label == 'Services provided'
          table.css('.services input[checked]').map{|i| i.next_sibling.text.strip}.join("\n")
        else
          tr.at_css('td + td')&.text
        end.strip

        if label.present? && value.present?
          data[label] = value
        end
      end
    end
    records << data
  end
end
headers = records.flat_map(&:keys).uniq
puts headers.to_csv
records.each do |rec|
  puts headers.map{|h| rec[h]}.to_csv
end

Run with ruby globaldownsyndrome.org.rb > ~/Google\ Drive/gds.org.csv