{
  "npi": "1215051099",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MS",
    "authorized_official_first_name": "ED",
    "authorized_official_last_name": "MOLDENHAUER",
    "authorized_official_middle_name": "D",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "6607264155",
    "authorized_official_title_or_position": "Executive Director",
    "enumeration_date": "2007-03-19",
    "last_updated": "2025-09-11",
    "organization_name": "GENTRY COUNTY ASSOCIATION FOR RETARDED CITIZENS, INC.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "106 S SMITH ST",
      "address_2": "P O BOX 2",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ALBANY",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "660-726-3916",
      "postal_code": "644021624",
      "state": "MO",
      "telephone_number": "660-726-4155"
    },
    {
      "address_1": "504 E DANIEL ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ALBANY",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "644021332",
      "state": "MO",
      "telephone_number": "660-726-5504"
    }
  ],
  "taxonomies": [
    {
      "code": "320900000X",
      "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "385HR2060X",
      "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}